[The colo-anal pouch: indications, function and results].
Low anterior resection of rectal cancer with preservation of the anal sphincter has comparable recurrence and survival rates when compared to abdominoperineal excision. Stool frequency and leakage rates are high after coloanal anastomosis. The colonic J-pouch improves function. Endosonographic tumor stages ES T1 and ES T2 for cancer in the distal third rectum and ES T3 tumors in die middle third rectum are indications for rectal resection with preservation of the sphincter and reconstruction with the colonic pouch. In 33 patients the technique was safe, with no deaths and no reoperation. Three diverting colostomies are not yet closed. 25 patients are perfect continent, two are incontinent for gas, three have minor and one patient major incontinence. Only one patient has more than three bowel movements in 24 hrs. For selected cancers of the distal half of the rectum total resection with preservation of the anal sphincter is a safe operation. Good function is provided by the colon J-pouch.
Abteilung für Allgemeine Chirurgie, Abdominal- und Gefässchirurgie, Universitätskliniken des Saarlandes, Homburg/Saar.
U
U
Hildebrandt
W
W
Lindemann
K W
KW
Ecker
P
P
Walter
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D005242:Fecal Incontinence / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D005772:Gastrointestinal Transit / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality; D016737:Proctocolectomy, Restorative / Q000379:methods*; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome
Der koloanale Pouch: Indikation, Funktion und Ergebnisse.