title: Straight and colonic J-pouch reconstruction after low anterior resection.
abstract: OBJECTIVE
  A complication after restorative rectal surgery with a straight anastomosis is low-anterior resection syndrome with a postoperatively deteriorated anorectal function. The colonic J-reservoir is sometimes used with the purpose of reducing these symptoms. An alternative method is to use a simple side-to-end anastomosis or a coloplasty.
  
  
  METHODS
  Three-hundred fiftyseven patients with rectal cancer undergoing total mesorectal excision (TME). Three-hundred (84.0%) received a low anterior resection with primary anastomosis and colo-rectal n = 194 (64.6%) or colo-anal anastomosis n = 106 (35.3%). A colonic pouch using the descending colon was created in 24 patients and in 75 patients respectively. Surgical results and complications were recorded. Patients were followed with a functional evaluation at 6 and 12 months postoperatively.
  
  
  RESULTS
  Patient characteristics in both groups were very similar regarding gender, age, tumor level, and Dukes' stages. A large proportion of the patients received short-term preoperative radiotherapy (72%). There was no significant difference in surgical outcome between the 2 techniques with respect to anastomotic height, perioperative blood loss, postoperative complications, reoperations, hospital stay or pelvic sepsis rates except the anastomotic stricture rate in the colonic J-Pouch group after coloanal anastomosis (p < 0.02).
  
  
  CONCLUSIONS
  These data show that either a colonic J-pouch or a straight anastomosis performed on the descending colon in low-anterior resection with TME are methods that can be used with similar expected surgical and functional results.
authors.affiliation: University Clinic of Surgery, General Hospital of Vienna.
authors.forename: B
authors.initials: B
authors.lastname: Teleky
authors.forename: Barbara
authors.initials: B
authors.lastname: Jech
authors.forename: Judith
authors.initials: J
authors.lastname: Karner-Hanusch
authors.forename: Irene
authors.initials: I
authors.lastname: Kuehrer
authors.forename: P
authors.initials: P
authors.lastname: Götzinger
authors.forename: F
authors.initials: F
authors.lastname: Herbst
authors.forename: R
authors.initials: R
authors.lastname: Jakesz
mesh_terms: D001003:Anal Canal / Q000601:surgery; D000714:Anastomosis, Surgical; D003106:Colon / Q000601:surgery*; D039021:Colonic Pouches; D006801:Humans; D011183:Postoperative Complications; D012004:Rectal Neoplasms / Q000601:surgery*; D012007:Rectum / Q000601:surgery*