Prospective randomized trial comparing J colonic pouch-anal anastomosis and straight coloanal reconstruction.
Twenty patients (13 men) with low rectal cancer, median (range) age 64.5 (38-83) years were prospectively randomized to undergo ultra-low anterior resection with a J colonic pouch-anal anastomosis (median (range) distance of anastomosis from the anal verge 3 (1-4) cm). Another 20 patients (15 men), median (range) age 62.5 (44-86) years) with low rectal cancer were randomized to a straight coloanal anastomosis (median (range) distance of anastomosis from the anal verge 3.25 (2-5) cm). There were no significant differences in operative time or complications between the two groups. There was significantly better postoperative anal function in patients who underwent pouch-anal anastomosis at 1, 6 and 12 months after ileostomy closure. At 12 months all patients (19 of 19) with a pouch reconstruction had regained normal continence compared with 14 of 20 of those who had a straight coloanal anastomosis. No patient complained of severe constipation requiring enema or intubation to evacuate.
Seow-Choen
F
F
Department of Colorectal Surgery, Singapore General Hospital.
Goh
H S
HS
D000230:Adenocarcinoma / Q000503:physiopathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000503:physiopathology / Q000601:surgery*; D000714:Anastomosis, Surgical / Q000379:methods; D003106:Colon / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D016737:Proctocolectomy, Restorative / Q000379:methods*; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000503:physiopathology / Q000601:surgery*