title: Laparoscopic intersphincteric resection and J-pouch reconstruction without laparotomy.
abstract: In some cases, a J-pouch is not created after laparoscopic intersphincteric resection (Lap-ISR), because this procedure usually does not involve laparotomy. This study aimed to develop a new technique for Lap-ISR and J-pouch reconstruction without laparotomy and to assess the short- and long-term outcomes of this technique. After a rectal specimen is excised using the transanal approach, the reconstructed intestine is reinserted into the intra-abdominal space. To create the J-shape, the reconstructed intestine is looped back using Allis forceps, and the septum of the J-shape is divided using a surgical stapler. We performed 20 surgeries using the new technique. Although three patients developed pelvic infections, no J-pouch-related complications were noted. Intestinal continuity could be maintained in all patients who received a diverting stoma.
authors.affiliation: Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan, beppu-n@hyo-med.ac.jp.
authors.forename: Naohito
authors.initials: N
authors.lastname: Beppu
authors.forename: Nagahide
authors.initials: N
authors.lastname: Matsubara
authors.forename: Masashi
authors.initials: M
authors.lastname: Noda
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Kimura
authors.forename: Naoki
authors.initials: N
authors.lastname: Yamanaka
authors.forename: Hidenori
authors.initials: H
authors.lastname: Yanagi
authors.forename: Naohiro
authors.initials: N
authors.lastname: Tomita
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome