Stelzner F ;

Chirurg vol. 66 (12)   pp. 1230-8, Dec 1995

Zentrum fur Operative Medizin, Rheinischen Freidrich-Wilhelms- Universitat Bonn.

The continence preserving procedures, even with small margins, have better curative results than amputation of the rectum. Nevertheless marginal continent resections have to take a defective continence into account. In clinical practice this is tolerated. A reason for the reduction of continence is the loss of the corpus cavernosum recti. Comparative anatomical investigations in Brachydanio, a fish species that is transparent in its larva stage, lead to the conclusion, that the rectum remains an abdominal organ even though it is situated in the lesser pelvis. Thus it is strictly separated from the totally differently developed pelvic organ of the urogenital system. This is also proven by the separate anlages of the lymph nodes, lymph and blood vessels. Concerning the continence organ it is referred to the formal sex difference. The female closure mechanism is weaker and more primitive. We could follow this principle back to the Latimeria. For this reason, after deep continent resections, women always are more subject to incontinence, and have to wear nightly pads, at times. We have operated on 328 patients during 1-1-1978 to 2-22-1989. Their curative rates relate to these considerations.

Animal ;  Comparative Study ;  Fecal Incontinence: pathology ;  Female ;  Fishes: anatomy & histology ;  Human ;  Male ;  Metamorphosis,Biological: physiology ;  Postoperative Complications: pathology ;  Rectal Neoplasms: pathology: surgery ;  Rectum: pathology: surgery ;  Sex Characteristics ;  Species Specificity ;  Zebrafish: anatomy & histology ;  29400 ;