Comparison between straight and J-pouch coloanal anastomoses in surgery for rectal cancer

Jen Kou Lin*, Huang Sheng Wang, Shung Haur Yang, Jeng Kae Jiang, Wei Shone Chen, Tzu Chen Lin

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

25 Scopus citations

Abstract

Purpose. This study was designed to compare the long-term results of straight and J-pouch coloanal anastomoses after resection of rectal cancers located in the critical position of 5-6 cm from the anal verge. Methods. The subjects of this study were 81 patients who underwent radical resection of rectal cancers located 5-6 cm from the anal verge, followed by straight or J-pouch coloanal anastomosis, performed in 41 and 40 patients, respectively. Careful clinical and manometric follow-up was conducted and the results were compared. Results. There were no differences in the incidence of local recurrence, the disease-free survival rate, postoperative stool frequency, continence, sphincter pressures, or functional length between the two groups. Both groups had a high incidence of clustering or fragmented defecation; however, the J-pouch patients had better urgency control, a greater capacity before feeling the urge to defecation, superior rectal tolerance, and better compliance. Conclusions. Both straight and J-pouch coloanal anastomoses are oncologically and functionally acceptable for the treatment of rectal cancer located 5-6 cm from the anal verge, but the J pouch has slight superiority in urgency control, as a result of larger urge threshold and tolerable volume, and better compliance. The reason for the high incidence of clustering defecation in both groups needs to be investigated.

Original languageEnglish
Pages (from-to)487-492
Number of pages6
JournalSurgery Today
Volume32
Issue number6
DOIs
StatePublished - 2002

Keywords

  • Carcinoma
  • Coloanal anastomosis
  • Colon pouch
  • Manometry
  • Rectum

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