Comparison of functional outcome of colonic J-pouch and latero-terminal anastomosis in low anterior resection for rectal cancer

Abstract

This trial did not reveal any significant differences in defecatory function 6, 12 and 24 months after low anterior resection (LAR) between patients with a latero-terminal anastomosis and those with colonic J-pouch anastomosis. Our results did not confirm superiority of colonic J-pouch over the latero-terminal anastomosis

Clinical Outcome After Rectal Replacement With Side-to-End, Colon-J-Pouch, or Straight Colorectal Anastomosis Following Total Mesorectal Excision

“…Markovic et al could not observe improved defecatory function upon CJP, as compared with SEA reconstruction, in a study including 80 patients, at 6, 12, and 24 months. 28 These results are largely in accordance with a meta-analysis by Si et al 15 and data from a randomized study by Machado et al 16 To our knowledge, our clinical trial is the largest prospective, randomized study in the field of rectal cancer surgery, investigating functional outcomes of 2 different pouch reconstruction techniques in comparison with SCA baseline treatment. Altogether, it has involved 15 hospitals, including universities, referral centers, and regional hospitals, each contributing from 1 to 44 rectal resections.…”

“…1). The 4 university centers, 4 referral centers, and 7 peripheral clinics contributed 104 (5-40), 152 (27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44), and 80 (1-33) patients, respectively. One hundred twelve patients were randomized to each treatment arm.…”

Safety and efficacy of side-to-end anastomosis versus colonic J-pouch anastomosis in sphincter-preserving resections: an updated meta-analysis of randomized controlled trials

“…Most of the studies were performed in Europe and Asia. The interventions of six studies [31][32][33][34][36][37][38] were comparisons between SEA and CJP anastomosis, and the other four studies [35,[39][40][41] were based on three-arm trials. A total of 864 patients were available for this meta-analysis, and the characteristics of the included studies are summarized in Table 1.…”

“…All the included studies provided data about bowel function except the study by Rasulov et al [39]. Three studies [36,37,40] could not be evaluated in the analysis because the bowel function data were evaluated by the validated Colorectal Functional Outcome (COREFO) questionnaire's summary score, the modified version of the Memorial Sloan-Kettering Cancer Center (MSKCC) questionnaire, and composite evacuation/incontinence scores. The original data were not available even though we tried to contact the corresponding authors.…”

“…All 10 RCTs [31][32][33][34][35][36][37][38][39][40][41] included protective stoma. However, the meta-analysis was performed including only seven RCTs [31-36, 39, 40] because the other three RCTs [37,38,41] showed that all patients were treated with protective stoma. No significant differences were observed among the groups (RR = − 1.09; 95% CI, 0.86-1.40; P = 0.47).…”