title: Functional outcome after coloanal anastomosis with J-colonic pouch for rectal cancer.
abstract: This study was designed to determine functional outcomes of restorative resections for carcinoma of the rectum. Between 1992 and 1995, 16 patients (8 male) of median age 75 (range 58-88) years underwent resection and coloanal anastomosis with J-colonic pouch reconstruction for rectal cancer. The distance of the lower border of tumor from the anal verge was 5 cm in 7 patients (43.70-0), 6 to 7 cm in 6 patients (37.0%) and 8 to 10 cm in 3 patients (18.7%). The Dukes staging was A in 4 patients (25%), B in 8 patients (50%) and C in 4 patients (25%). Coloanal anastomosis was performed by hand in 4 patients (25%) or with stapler in 12 patients (75%). Seven patients (43.7%) had diverting stoma. No patient died following surgery. Pelvic sepsis and anastomotic dehiscence that required pouch excision occurred in two patients (12.5%). Fourteen patients were evaluated. The mean follow-up was 15 (range 5-23) months. No patient developed recurrent pelvic tumor. Satisfactory fecal continence was achieved by 85.7% of patients. Stool frequency was 1-2 per day in 12 patients (85.7%). Three patients (21.4%) had minor soiling. Five patients (35.7%) occasionally complained urgency. There was no apparent difference between the patients with manual or stapled coloanal anastomosis. Coloanal anastomosis with J-colonic pouch is associated with an excellent long-term outcome.
authors.affiliation: Department of Surgery, Royal Infirmary of Edinburgh, Scotland, U.K.
authors.forename: G A
authors.initials: GA
authors.lastname: Santoro
authors.forename: K R
authors.initials: KR
authors.lastname: Makhdoomi
authors.forename: B Z
authors.initials: BZ
authors.lastname: Eitan
authors.forename: D C
authors.initials: DC
authors.lastname: Bartolo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000601:surgery*; D000714:Anastomosis, Surgical / Q000379:methods; D003106:Colon / Q000601:surgery*; D003672:Defecation; D005242:Fecal Incontinence / Q000503:physiopathology / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016737:Proctocolectomy, Restorative / Q000379:methods*; D012004:Rectal Neoplasms / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome