Comparison of a colonic J-pouch and transverse coloplasty pouch in patients with rectal cancer after an ultralow anterior resection using fecoflowmetric profiles.
OBJECTIVE
Because the standard straight coloanal anastomosis for low rectal cancer tends to result in unfavorable outcomes in terms of defecatory function, colonic pouch reconstruction has therefore recently been adopted in many institutions. The colonic J-pouch (CJP)- and transverse coloplasty pouch (TCP)-anal anastomoses have been adopted worldwide. However, the comparative benefits and drawbacks of the two procedures are uncertain. This study was designed to analyze the functional and clinical outcomes after an ultralow anterior resection (ULAR) using the fecoflowmetry (FFM).


METHODS
Between November 1996 and July 2005, 18 patients were studied retrospectively. They were evaluated by FFM, together with Kelly's clinical score (KCS), and anorectal manometric assessments were also performed.


RESULTS
The KCS directly correlated to the maximum fecal stream flow rate (Fmax). In this study, postoperative patients with good KCS as well as a high value of Fmax were seen more in the patients with CJP than in those with TCP.


CONCLUSIONS
From the viewpoint of FFM, the patients with CJP had a more favorable functional outcome than those with TCP. FFM provided quantitative and qualitative evaluations concerning the anorectal motor activity in patients who had undergone an ULAR for rectal cancer.
Kobayashi
Yasuo
Y
Department of Gastrointestinal Surgery, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachi-dori, Chyuo-ku, Niigata, Niigata 951-8510, Japan. kobayasu@med.niigata-u.ac.jp
Yasuo
Kobayashi
K
Yagi
Minoru
M
Minoru
Yagi
Y
Iiai
Tsuneo
T
Tsuneo
Iiai
I
Tani
Tatsuo
T
Tatsuo
Tani
T
Maruyama
Satoshi
S
Satoshi
Maruyama
M
Hatakeyama
Katsuyoshi
K
Katsuyoshi
Hatakeyama
H
D000328:Adult; D000368:Aged; D003106:Colon / Q000601:surgery*; D039021:Colonic Pouches; D003672:Defecation / Q000502:physiology*; D013505:Digestive System Surgical Procedures / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011182:Postoperative Care; D012004:Rectal Neoplasms / Q000503:physiopathology* / Q000601:surgery*