Function after anoabdominal rectal resection and colonic J pouch-anal anastomosis

Abstract

Twenty-eight patients undergoing anoabdominal resection of the rectum with construction of a colonic J reservoir and eight patients without a reservoir were studied 2 years after surgery. Frequency of defaecation and daytime soiling were inversely correlated with the maximum tolerable volume of the colonic J pouch. The distensibility and threshold volume of those with a pouch were significantly greater than in those without a pouch 6 months or more after stoma closure. Anal resting pressure, squeeze pressure, anal canal length and a positive inhibitory reflex were similar in both groups. Anal resting pressure, squeeze pressure and pouch distensibility correlated with frequency of defaecation in the stable phase. Pouch construction may improve the patient's quality of life in the adaptation phase.

Causes and Prevention of Functional Disturbances Following Low Anterior Resection for Rectal Cancer

“…In 11 out of 12 controlled studies (5,40,43,52,54,64,49,102,143,160,162), compliance was higher in the pouch group than in the group with straight colorectal or coloanal anastomosis, in 9 studies significantly so. In 8 studies (32,50,64,82,88,123,160,162) SV was lower in the group without pouch, the majority significantly so compared with the pouch group. The studies on volumetric parameters confirm the better reservoir function of the pouch compared with straight coloanal or colorectal anastomosis.…”

“…In numerous controlled studies volumetric parameters of reservoir function, such as MTV, SV and compliance, were examined. In 13 out of 16 studies a significantly higher MTV was measured in the pouch group compared with the group without a pouch ( 5,32, 43,52,54,64,69,82,86,102,118,122,123,160,162). In most studies the patients were examined one year post-operatively.…”

Prospective, Randomized Trial Comparing a 3- versus 6-Stitch Purse-String Suture in Stapled Hemorrhoidopexy

“…All patients underwent continence evaluation using anorectal manometry before surgery, as previously described [9]. This was repeated 1 month after the operation to assess postoperative function.…”

Apical Pouch Bridge Syndrome after IIeal J Pouch-Anal Anastomosis

“…The data were ana lyzed with a customized LA-555 program (PIPS Co. Ltd., Calif., USA). Anal manometry was performed using an open-tip catheter and latex balloon as described previously [7,8]. Statistical analysis was carried out using the Mann-Whitney U test.…”