Colonic J-pouch rectal reconstruction--is it really a neorectum?
OBJECTIVE
The aim of this study was to determine whether a colonic J-pouch has similar properties to that of a normal rectum, including recovery of rectoanal coordination.


METHODS
Ten patients with colonic J-pouch-anal anastomosis (anastomotic distance from anal verge, 3.5 (range, 2.0-4.5) cm for low rectal cancer (7 men; mean age, 64.7 (range, 44-76) years) were studied clinically and in the anorectal physiology laboratory at least one year after operation. Results were compared with a series of ten matched patients who underwent high anterior resection for upper rectal carcinoma (anastomotic height, 12.7 (range, 9.5-16) cm).


RESULTS
Although results seemed to be slightly better in the group with the rectum preserved, no statistical differences could be found either in functional outcome or anorectal physiology. One-half of the patients with colonic J-pouch (neorectum) had a positive rectoanal inhibitory reflex.


CONCLUSIONS
Addition of a colon pouch neorectum would appear to improve function to the level of those patients with a high anastomosis and "normal" rectum.
Ramirez
J M
JM
Department of Colorectal Surgery, John Radcliffe Hospital, Oxford, United Kingdom.
Mortensen
N J
NJ
Takeuchi
N
N
Smilgin Humphreys
M M
MM
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011312:Pressure; D016737:Proctocolectomy, Restorative; D012004:Rectal Neoplasms / Q000601:surgery*; D012007:Rectum / Q000503:physiopathology; D016896:Treatment Outcome