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Anal Sphincter Preservation or Replacement after Rectal Cancer

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Last Modified: October 23, 2005

Dear OncoLink "Ask The Experts,"
My brother was operated on for rectal cancer and had the anal sphincter removed. I was wondering if you know if anyone does rectal and sphincter reconstruction? Thank you very much.

Najjia N. Mahmoud, MD, Assistant Professor of Surgery at the Hospital of the University of Pennsylvania in the Division of Colon and Rectal Surgery, responds:

Preservation of the anal sphincters and distal rectum is an option for certain people who have mid or high rectal cancers. If the rectal cancer is low or involves the anal sphincters, then complete removal of the rectum is necessary. Sphincter preservation can be done in other diseases, but not in ultra-low rectal cancer involving the muscle, as the chances of recurrence would be unacceptably high, in general. Once the sphincters are removed, there unfortunately is no good way to replace that mechanism, or to create an artificial rectum.

For patients with a permanent colostomy, there are on-line societies and organizations, as well as clubs or meetings in many communities, for dealing with the problems associated with the ostomy. The most well-known group is the United Ostomy Association. Many communities also have nurses or nurse practitioners who specialize in the care of stomas and in helping people with colostomies to solve problems associated with their use.