期刊
SURGERY TODAY
卷 32, 期 2, 页码 104-110出版社
SPRINGER-VERLAG
DOI: 10.1007/s005950200001
关键词
low anterior resection; stapled anastomosis; colonic J-pouch; defecatory function; anorectal physiology
类别
Purpose. Although defecatory function after low anterior resection for rectal cancer is reported to be better following colonic J-pouch than straight anastomosis, few prospective randomized trials comparing the two form of anastomosis have been reported. We performed a prospective randomized trial comparing straight anastomosis with colonic J-pouch anastomosis both clinically and physiologically in patients undergoing stapled low colorectal anastomosis. Methods. A total of 42 consecutive patients were intraoperatively randomized to undergo either straight anastomosis or colonic J-pouch anastomosis. Clinical defecatory function was evaluated by a questionnaire answered preoperatively, then 6 and 12 months postoperatively. Anorectal physiological assessment was also carried out before surgery, then 12 months postoperatively. Results. The clinical defecatory function assessed 6 months and 12 months after surgery did not differ between the two groups. However, while the length of high-pressure zone was significantly shortened, and (neo)rectal capacity was significantly reduced postoperatively in the straight group, none of these physiological parameters were significantly altered in the pouch group. Conclusion. Although the aim of colonic J-pouch to preserve reservoir function was physiologically achieved, the improvement in clinical defecatory function was not significant. Thus, further prospective studies are needed to confirm the functional superiority of colonic J-pouch anastomosis for stapled low colorectal anastomosis after low anterior resection.
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