Defecatory Function Following Local Excision of Rectal Masses

Local excision is currently playing a greater role in the treatment of benign and early stage malignant lesions. In addition to achieving good oncologic results with minimal morbidity and mortality, it is important to maintain good rectal function. This chapter reviews defecatory function following traditional transanal excision as well as transanal endoscopic microsurgery. Factors which affect anorectal function in association with local excision are pre-surgical function, surgical technique, the length of surgery, the amount of rectal wall excised, and perhaps most importantly, the use of adjuvant radiation therapy. The vast majority of individuals who undergo local excision of rectal masses with either standard techniques or transanal endoscopic microsurgical resection will have little impairment of anorectal function following surgery.