Sphincter Sparing Operations
 
In the past any diseases involving the end of the rectum required removal of the anus and creation of a permanent colostomy. This was typical for rectal cancer and even for some benign diseases.
 
Through advances in technology and our understanding of physiology and pathology we can now "spare" the sphincter in the majority of patients. Technological advances include better exposure and control of bleeding during surgery as well as mechanical stapling devices to reconnect the bowel in areas  we cannot reach for a hand sutured connection. We also now know that we don't need as much of a clearance margin in cancer if we give patients preoperative radiation therapy well timed with the surgery. 
 
We also learn that instead of connecting the remaining bowel straight to the anus we better create an internal pouch by folding it over itself so that we create a reservoir. With all these advances we can preserve the sphincter and enable patients to continue eliminating stool through the anus.
 
In most patients this results in a significant change in the way they eliminated stool before, sometimes with more frequency and decreased consistency and sometimes with occasional leakage. However, most patients are very satisfied with the option of preserving their anal sphincter.

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