肛門温存手術によって術後排便障害がなぜ発症するのか、その機序とこれを回避する方法に関して研究を行ってきました。

1. Atsushi Hirano, Keiji Koda, Chihiro Kosugi, Masato Yamazaki, Hideki Yasuda.Damage to anal sphincter/levator ani muscles caused by operative procedure in anal sphincter-preserving operation for rectal cancer Am J Surg. 201:508-513, 2011.

2. Yoji Takami, Christopher R Mantyh, Theodore N Papas, Toku Takahashi, Keiji Koda, Masaru Miyazaki.  Extrinsic surgical denervation ameliorates TNBS-induced colitis in Rats.  Hepato-Gastroenterol 2009; 56: 682-686.

3. Keiji Koda , Hideki Yasuda , Atsushi Hiranom, Chihiro Kosugi, Masato Suzuki, Masato Yamazaki,Toru Tezuka, Ryota Higuchi, Hiroki Tsuchiya, Norio Saito.  Evaluation of postoperative damage to anal sphincter/levator ani muscles with 3-dimensional vector manometry following sphincter-preserving operation for rectal cancer.  J Am Col Surg 208(3): 362-367, 2009.

4. 幸田圭史, 安田秀喜, 鈴木正人、山崎将人, 手塚徹, 小杉千弘, 樋口亮太, 杉本真樹,　平野敦史、植村修一郎、土屋博紀　消化管再建術の現状と将来−最良の再建法はなにか−　日本外科学会雑誌　１０９（５）：２７４−２７７、２００８． 

5. Masato Morihiro, Keiji Koda, Kazuhiro Seike, Hideaki Miyauchi,and Masaru Miyazaki  Characteristic findings on defecography according to reconstruction method and defecatory disorder following sphincter-saving surgery for rectal cancer.  Int J Colorectal Dis 23:883-892, 2008.

6. Masaki Nishimura, Keiji Koda, Kenji Oda, Kazuhiro Seike, Kimio Shimizu, Masaru Miyazaki.  Mesentery Transection Decreases the Expression of Interstitial Cells of Cajal in Rat Colon. 　Br J Surg 94(4): 483-490, 2007.

7. Kazuhiro Seike, Keiji Koda, Norio Saito, Kenji Oda, Chihiro Kosugi, Kimio Shimizu, Masaru Miyazaki.　Laser Doppler measurement of anastomotic blood flow in rectosigmoid colon cancer surgery and its predictive value for anastomotic ischemia.  Int J colorectal Dis. 22(6):689-697, 2007.

8. Masaki Nishimura, Keiji Koda, Kenji Oda, Kazuhiro Seike, Chihiro Kosugi, Kimio Shimizu, Toru Tonooka, and Masaru Miyazaki.  Decreased interstitial cells of Cajal in the neorectum after anterior resection of the rectum.  Hepato-Gastroenterol 53: 665-668, 2006.

9. Saito N, Moriya Y, Shirouzu K, Maeda K, Mochizuki H, Koda K, Hirai T, Sugito M, Ito M, Kobayashi A.  Intersphincteric resection in patients with very low rectal cancer: A review of the Japanese experience.  Dis Col Rectum 49(10)S13-22, 2006

10. Kimio Shimizu, Keiji Koda*, Yoshio Kase, Kazuko Satoh, Kazuhiro Seike, Masaki Nishimura, Chihiro Kosugi, Masaru Miyazaki.  Induction and recovery of colonic motility/defecatory disorders following extrinsic denervation of the colon and rectum in rats. Surgery 139(3):395-406, 2006.

11. Keiji Koda*, Norio Saito, Kazuhiro Seike, Kimio Shimizu, Chihiro Kosugi, Masaru Miyazaki.  Denervation of the neorectum as a potential cause of defecatory disorder following low anterior resection for rectal cancer  Dis Col Rectum 48, 210-217, 2005.

12. Isamu Iizuka, Keiji Koda*, Kazuhiro Seike, Kimio Shimizu, Yoji Takami, Hiroyuki Fukuda, Daisuke Tsuchida, Kenji Oda, Nobuhiro Takiguchi, Masaru Miyazaki.  Defecatory malfunction caused by motility disorder of the neorectum after anterior resection for rectal cancer.  Am J Surg  188:176-180, 2004.

近年では人工肛門の造設方法も比較的日本中で統一化されてきており、また、専門知識と技量のある看護師が多数日本でも活躍しています。　

人工肛門の装具の改良も目覚ましいものがあり、これらのことから人工肛門を持ちながら日常生活を活気を持って送られている人たちが当院でも多数おられます。　

また肛門温存手術後に排便障害で苦労されながらも、いろいろな工夫で日常生活を満喫されておられる方もおられます。　

排泄は生活にとって大変大事な機能ですから、どういう治療を選択するのか個々の患者さんと今後もよく相談して方針を決定しますし、どちらの場合でもわれわれは責任を持って対応させていただきます。