Straight and colonic J-pouch reconstruction after low anterior resection.
نویسندگان
چکیده
PURPOSE A complication after restorative rectal surgery with a straight anastomosis is low-anterior resection syndrome with a postoperatively deteriorated anorectal function. The colonic J-reservoir is sometimes used with the purpose of reducing these symptoms. An alternative method is to use a simple side-to-end anastomosis or a coloplasty. MATERIAL AND METHODS Three-hundred fiftyseven patients with rectal cancer undergoing total mesorectal excision (TME). Three-hundred (84.0%) received a low anterior resection with primary anastomosis and colo-rectal n = 194 (64.6%) or colo-anal anastomosis n = 106 (35.3%). A colonic pouch using the descending colon was created in 24 patients and in 75 patients respectively. Surgical results and complications were recorded. Patients were followed with a functional evaluation at 6 and 12 months postoperatively. RESULTS Patient characteristics in both groups were very similar regarding gender, age, tumor level, and Dukes' stages. A large proportion of the patients received short-term preoperative radiotherapy (72%). There was no significant difference in surgical outcome between the 2 techniques with respect to anastomotic height, perioperative blood loss, postoperative complications, reoperations, hospital stay or pelvic sepsis rates except the anastomotic stricture rate in the colonic J-Pouch group after coloanal anastomosis (p < 0.02). CONCLUSIONS These data show that either a colonic J-pouch or a straight anastomosis performed on the descending colon in low-anterior resection with TME are methods that can be used with similar expected surgical and functional results.
منابع مشابه
Randomized comparison of straight and colonic J pouch anastomosis after low anterior resection.
OBJECTIVE The authors compared clinical bowel function and complications of a low anterior resection with either a straight or colonic J pouch anastomosis. SUMMARY BACKGROUND DATA Urgency and frequent bowel movements after rectal resection with a low anastomosis have been related to the loss of rectal reservoir function. Reconstruction with a colonic J pouch possibly can obviate some of this ...
متن کاملMeta-analysis of reconstruction techniques after low anterior resection for rectal cancer.
BACKGROUND Options for reconstruction after low anterior resection (LAR) for rectal cancer include straight or side-to-end coloanal anastomosis (CAA), colonic J pouch and transverse coloplasty. This systematic review compared these techniques in terms of function, surgical outcomes and quality of life. METHODS A systematic literature search (MEDLINE, Embase and the Cochrane Library, from ince...
متن کاملComparison of long-term functional results of colonic J-pouch and straight anastomosis after low anterior resection for rectal cancer: a five-year follow-up.
PURPOSE Few reports on the long-term functional outcome of colonic J-pouch reconstruction have been published, and data comparing J-pouch and straight reconstruction are contradictory. This prospective study compares the functional outcome of colonic J-pouch and straight anastomosis five years after low anterior resection for rectal cancer. METHODS Functional outcome was compared in 46 patien...
متن کاملFunctional results after TME: J-pouch vs straight coloanal anastomosis and role of neoadjuvant radiochemotherapy.
AIM Purpose of this study was to evaluate short and long term functional outcomes after TME (total mesorectal excision) for rectal cancer. The role of straight anastomosis or colonic J-pouch reconstruction is investigated, as well as the impact of preoperative chemoradiotherapy is analyzed as a cause of the so called "anterior resection syndrome". METHODS We enrolled 40 patients (17 male and ...
متن کاملComparison 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 can...
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ورودعنوان ژورنال:
- Acta chirurgica Iugoslavica
دوره 53 2 شماره
صفحات -
تاریخ انتشار 2006