Physiological anorectal reconstruction with pudendal nerve anastomosis and a colonic S-pouch after abdominoperineal resection: Report of 2 successful cases

Abstract

Abdominal stoma is a morbidity. A neo-anus has recently been reconstructed with an electrically stimulated neo-sphincter 1 Mander BJ Abercrombie JF George BD Williams NS The electrically stimulated gracilis neosphincter incorporated as part of total anorectal reconstruction after abdominoperineal excision of the rectum. Ann Surg. 1996; 224: 702-709 Crossref PubMed Scopus (59) Google Scholar , 2 Geerdes BP Zoetmulder FAN Heineman E Vos EJ Rongen MJ Baeten CG Total anorectal reconstruction with a double dynamic graciloplasty after abdominoperineal reconstruction for low rectal cancer. Dis Colon Rectum. 1997; 40: 698-705 Crossref PubMed Scopus (49) Google Scholar , 3 Cavina E. Outcome of restorative perineal graciloplasty with simultaneous excision of the anus and rectum for cancer; a ten-year experience with 81 patients. Dis Colon Rectum. 1996; 39: 182-190 Crossref PubMed Scopus (50) Google Scholar with the aim of creating a sphincter of sufficient strength. The clinical results, however, have so far been rather disappointing. 1 Mander BJ Abercrombie JF George BD Williams NS The electrically stimulated gracilis neosphincter incorporated as part of total anorectal reconstruction after abdominoperineal excision of the rectum. Ann Surg. 1996; 224: 702-709 Crossref PubMed Scopus (59) Google Scholar , 2 Geerdes BP Zoetmulder FAN Heineman E Vos EJ Rongen MJ Baeten CG Total anorectal reconstruction with a double dynamic graciloplasty after abdominoperineal reconstruction for low rectal cancer. Dis Colon Rectum. 1997; 40: 698-705 Crossref PubMed Scopus (49) Google Scholar , 3 Cavina E. Outcome of restorative perineal graciloplasty with simultaneous excision of the anus and rectum for cancer; a ten-year experience with 81 patients. Dis Colon Rectum. 1996; 39: 182-190 Crossref PubMed Scopus (50) Google Scholar Other natural anal functions and a greater sphincteric strength may be needed to achieve fecal continence.