Misconceptions about the colonic J-pouch: what the accumulating data show.
BACKGROUND
Since 1986 when the colonic J-pouch-anal anastomosis was first described, it has gained increasing acceptance as the operation of choice for low rectal cancer surgery. However, there still exist several misconceptions about its use, namely anastomotic complications, alterations in anorectal physiology, and functional outcome.


METHODS
All relevant articles derived from MEDLINE databases from 1986 to the present were reviewed. Emphasis was placed on reviewing the features that are claimed to make the colonic J-pouch-anal anastomosis superior to a straight anastomosis.


CONCLUSIONS
The colonic J-pouch has a role in ultra-low rectal cancer surgery, with an apparent reduction in the incidence of anastomotic leaks and reduced bowel frequency. Continence is unchanged and defecatory difficulties can be reduced by constructing a small pouch (< or =5 cm).
Dennett
E R
ER
Department of Surgery, Faculty of Medicine and Health Science, Auckland University, New Zealand.
Parry
B R
BR
D006801:Humans; D011183:Postoperative Complications / Q000453:epidemiology; D016737:Proctocolectomy, Restorative / Q000706:statistics & numerical data; D012004:Rectal Neoplasms / Q000601:surgery*; D016896:Treatment Outcome