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  • Title: Functional results of colonic J-pouch anastomosis for rectal cancer.
    Author: Araki Y, Isomoto H, Tsuzi Y, Matsumoto A, Yasunaga M, Yamauchi K, Hayashi K, Kodama T.
    Journal: Surg Today; 1999; 29(7):597-600. PubMed ID: 10452235.
    Abstract:
    The purpose of this study was to clarify the functional outcomes of colonic J-pouch anastomosis (J-LAR) for lower rectal cancer in comparison with those of traditional straight anastomosis (S-LAR). A questionnaire regarding anorectal function was conducted 1 year after operation on patients who underwent J-LAR (n = 15) and S-LAR (n = 30). The clinical functions were assessed by an incontinence scoring system. The physiologic function was assessed by anorectal manometry and the balloon expulsion test. No patients demonstrated a diverting stoma. The bowel frequency (range) 1 year after operation was 4.8 (3-6) in the S-LAR group and significantly decreased to 1.8 (1-3) in the J-LAR group (P < 0.05). Complete evacuation was 50.2% (40%-60%) in the S-LAR group and significantly increased to 80.6% (60%-90%) in the J-LAR group (P < 0.05). Neorectal compliance was 2.2 (1.4-2.9) ml/mmHg in the S-LAR group and significantly increased to 3.1 (1.3-3.5) ml/mmHg in the J-LAR group (P < 0.01). No significant difference was observed between the two groups regarding the maximum resting or maximum voluntary squeezing pressure. In conclusion, our findings suggested colonic pouch anastomosis performed after a low anterior resection to support the compliance of the (neo)rectum to be an important factor for retaining a satisfactory bowel frequency.
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