Comparison of functional and clinical outcomes: colonic J-pouch vs. coloplasty in patients with low rectal cancer.
OBJECTIVE
Coloplasty has been reported as substitution to colonic J-pouch when it is difficult to fashion. However, previous studies showed conflicting results with reference to functional outcome.


METHODS
Forty-seven patients with low rectal cancer were involved in this study from July 2000 to December 2006. Coloplasty was performed when colonic J-pouch was hard to construct due to technical difficulty such as short masenterium and narrow pelvis. Clinical and functional evaluations were performed before the operation and 12 months after stoma closure.


RESULTS
Colonic J-pouch was abandoned in 12 of 37 cases (26%) due to short colon and mesenterium in 8 cases and narrow pelvis in 4 cases. Frequency of daily bowel movement was significantly increased in both groups but no difference between the groups. Anal sphincter tones were maintained even after the operation. Moreover, no difference was noted between the groups. Anal canal length and sensory factor were also maintained. Volumetric factors such as maximum tolerable volume and neo-rectal capacity showed significant changing before and after the operation. However, there was no significant difference between the groups.


CONCLUSIONS
Coloplasty could be a possible substitution to colonic J-pouch in patients with low rectal cancer from functional point of view.
Matsuoka
Hiroyoshi
H
Department of Surgery, Kyorin University, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan. hmatsu@ks.kyorin-u.ac.jp
Masaki
Tadahiko
T
Kobayashi
Takaaki
T
Sato
Kazunori
K
Sugiyama
Masanori
M
Atomi
Yutaka
Y
D000368:Aged; D001003:Anal Canal / Q000503:physiopathology; D003106:Colon / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D039021:Colonic Pouches; D003672:Defecation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016737:Proctocolectomy, Restorative; D011446:Prospective Studies; D020127:Recovery of Function; D012004:Rectal Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome