Comparison of Colonic J-pouch and Straight Coloanal anastomosis after Low Anterior Resection

OBJECTIVE To evaluate the effect of colonic J-pouch coloanal anastomosis after low anterior resection for mid or low rectal cancer on improving defecation and anorectal physiology. METHODS To make a meta-analysis, prospective randomized controlled trial of with or without colonic J-pouch after low anterior resection for mid or low rectal cancer was conducted. The key words included rectal cancer, J-pouch (or J-pouch) and those randomized from selected reports. The data on bowel function and physiological function of the anal canal and (neo) rectum were meta-analyzed using fixed effect model and random effect model. RESULTS Eight randomized trails including 378 patients entered this study. After one year follow-up, the functional results showed that there were significant differences in stool frequency per day, urgency and use of medication between colonic J-pouch group and straight coloanal anastomosis group. On physiological function of the anal canal and (neo) rectum, there was significant difference only in rectal compliance between the two groups. But there was no significant difference in other 4 items. CONCLUSIONS The functional improvement gained from colonic J-pouch coloanal anastomosis continues to benefit the patient with mid or low rectal cancer for at least 12 months. It is necessary to further study about the effect of colonic J-pouch coloanal anastomosis on physiological function of the anal canal and (neo) rectum.