Colonic J-pouch decreases bowel frequency by improving the evacuation ratio.
OBJECTIVE
To compare the functional outcome of ultra-low anterior resection for rectal cancer with colonic J-pouch reconstruction with that of straight reconstruction.


METHODS
Twenty-three patients who underwent ultra-low anterior resection with or without J-pouch reconstruction underwent bowel transit study, videodefecography, and answered a questionnaire survey 4 months and 1 year after surgery. Eleven healthy subjects underwent similar testing as controls.


RESULTS
Patients with a J-pouch had less frequent stools than patients with straight reconstruction 4 months after surgery (p<0.05), but the two groups were similar at 1 year. Bowel transit time was similar at both study points. The evacuation ratio was higher after J-pouch than straight reconstruction 4 months after surgery (p<0.05). However, the ratio improved in the straight group, and no difference existed at 1 year. Colonic contraction was seen only near the anastomosis 4 months after surgery, but the contraction proximal to the anastomosis improved over the next 8 months.


CONCLUSIONS
J-pouch reconstruction facilitates evacuation by improving the evacuation ratio. Although straight anastomosis caused excessive stool frequency 4 months after surgery, colonic function continued to improve and was comparable with J-pouch and straight reconstruction 1 year after surgery because the contraction ratio proximal to the anastomosis improved.
Kimura
H
H
Second Department of Surgery, Yokohama City University School of Medicine, Yokohama, Japan. kfc04274@nifty.com
Shimada
H
H
Ike
H
H
Yamaguchi
S
S
Ichikawa
Y
Y
Kikuchi
M
M
Fujii
S
S
Ohki
S
S
D000368:Aged; D000714:Anastomosis, Surgical; D003106:Colon / Q000601:surgery*; D039021:Colonic Pouches; D003672:Defecation; D019841:Defecography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome