Functional results of colonic J-pouch anastomosis for rectal cancer.
The purpose of this study was to clarify the functional outcomes of colonic J-pouch anastomosis (J-LAR) for lower rectal cancer in comparison with those of traditional straight anastomosis (S-LAR). A questionnaire regarding anorectal function was conducted 1 year after operation on patients who underwent J-LAR (n = 15) and S-LAR (n = 30). The clinical functions were assessed by an incontinence scoring system. The physiologic function was assessed by anorectal manometry and the balloon expulsion test. No patients demonstrated a diverting stoma. The bowel frequency (range) 1 year after operation was 4.8 (3-6) in the S-LAR group and significantly decreased to 1.8 (1-3) in the J-LAR group (P < 0.05). Complete evacuation was 50.2% (40%-60%) in the S-LAR group and significantly increased to 80.6% (60%-90%) in the J-LAR group (P < 0.05). Neorectal compliance was 2.2 (1.4-2.9) ml/mmHg in the S-LAR group and significantly increased to 3.1 (1.3-3.5) ml/mmHg in the J-LAR group (P < 0.01). No significant difference was observed between the two groups regarding the maximum resting or maximum voluntary squeezing pressure. In conclusion, our findings suggested colonic pouch anastomosis performed after a low anterior resection to support the compliance of the (neo)rectum to be an important factor for retaining a satisfactory bowel frequency.
Araki
Y
Y
Department of Surgery, Kurume University Medical Center, Japan.
Isomoto
H
H
Tsuzi
Y
Y
Matsumoto
A
A
Yasunaga
M
M
Yamauchi
K
K
Hayashi
K
K
Kodama
T
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000502:physiology / Q000601:surgery; D000714:Anastomosis, Surgical / Q000534:rehabilitation; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D017060:Patient Satisfaction; D016737:Proctocolectomy, Restorative / Q000379:methods / Q000534:rehabilitation*; D012004:Rectal Neoplasms / Q000534:rehabilitation* / Q000601:surgery; D012007:Rectum / Q000502:physiology / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome