[Restorative proctectomy. A comparison of direct colo-anal and colon-pouch-anal anastomoses for reconstructing continuity].
Thirty-nine of 63 patients undergoing deep anterior rectal resection received a straight coloanal anastomosis (CAA); the remaining 24 patients additionally had a colon-j-pouch (CPA) constructed. After pouch-anal anastomosis, local septic complications occurred in 12.5% of patients compared to 20.5% after coloanal anastomosis. Stool frequency after pouch-anal anastomosis was 3.3 per 24 h compared to 5.2 per 24 h after straight anastomosis within the first year after ileostomy closure (P = 0.053). Continence was slightly better in the pouch group (n.s.), and anal manometry showed a significant postoperative decrease only in resting pressure after straight colonal anastomosis (P < 0.001). This study supports the construction of a colon-j-pouch after deep rectal resection, as the pouch-anal anastomosis has fewer local septic complications and seems to improve functional outcome.
Kienle
P
P
Chirurgische Klinik und Poliklinik, Universitätsklinik Heidelberg.
Stern
J
J
Herfarth
C
C
D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000601:surgery; D000714:Anastomosis, Surgical / Q000379:methods*; D003106:Colon / Q000601:surgery; D005242:Fecal Incontinence / Q000209:etiology / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology; D016737:Proctocolectomy, Restorative / Q000379:methods*; D012004:Rectal Neoplasms / Q000601:surgery*; D013528:Surgical Staplers