title: Long-term functional results from a randomized clinical study of transverse coloplasty compared with colon J-pouch after low anterior resection for rectal cancer.
abstract: BACKGROUND
  The colonic pouch is considered as an alternative to the standard straight low anastomosis after resection for rectal cancer. The aim of this prospective randomized trial was to compare short- and long-term functional results of colonic J-pouch (CJP) and transverse coloplasty (TCP) after low anterior resection for rectal cancer.
  
  
  METHODS
  Between 2000 and 2005, patients with mid or low rectal cancer scheduled for an elective sphincter-preserving resection were eligible. The primary end point was to compare bowel functional results 6 months and 3 years after ileostomy closure. Fecal incontinence score and a questionnaire that included items for clinical evaluation of bowel function were used.
  
  
  RESULTS
  One-hundred six patients were randomized; 54 patients were allocated to the CJP group and 52 in the TCP group. There were no differences between the 2 groups in terms of demographic and clinical data. Overall, postoperative complication rate was 19.8% without differences between the groups. Two patients (1.9%; one in each group) presented with anastomotic dehiscence. Long-term incomplete evacuation rates were 29.2% in the CPT group and 33.3% in the CJP group, without substantial differences. Overall, short- and long-term functional outcomes of both procedures were comparable. No differences were observed in terms of fecal incontinence or in all the items included in the questionnaire.
  
  
  CONCLUSIONS
  TCP reconstruction after rectal cancer resection and coloanal anastomosis is functionally similar to CJP both in short- and long-term outcomes. The TCP technique does not seem to improve significantly the incomplete defecation symptom respect to CJP.
  
  
  BACKGROUND
  NCT01396928; http://register.clinicaltrial.gov.
authors.affiliation: Department of General and Digestive Surgery, Colorectal Unit, Bellvitge University Hospital, University of Barcelona and IDIBELL, Barcelona, Spain. sbn.biondo@gmail.com
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Biondo
authors.forename: Ricardo
authors.initials: R
authors.lastname: Frago
authors.forename: Antonio
authors.initials: A
authors.lastname: Codina Cazador
authors.forename: Ramon
authors.initials: R
authors.lastname: Farres
authors.forename: Francisco
authors.initials: F
authors.lastname: Olivet
authors.forename: Thomas
authors.initials: T
authors.lastname: Golda
authors.forename: Bernat
authors.initials: B
authors.lastname: Miguel
authors.forename: Esther
authors.initials: E
authors.lastname: Kreisler
mesh_terms: D000368:Aged; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D006801:Humans; D007081:Ileostomy / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome