Anal sphincteric resection for rectal cancer is most commonly followed by colostomy in the lower abdominal wall, which enforces quite a poor quality of life due to a permanent stoma. For surgeons treating lower rectal cancer, the goal is to achieve defecation via the anus without placing a stoma. Internal sphincteric resection, partial external sphincteric resection and coloanal anastomosis have been reported for the treatment of lower rectal cancer with avoiding a colostoma. Extended resection of the external sphincter, however, limits patient's daily activities because of poor functional results and necessitates reconstruction of damaged anal function. This paper describes a case of graciloplasty for postoperative anal dysfunction that yielded a good clinical outcome in a 65-year-old female who had undergone very low anterior resection with complete internal and partial external sphincteric resection for lower rectal cancer.
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