Introduction. Functional results after low anterior resection for rectal
cancer are an issue of increasing attention among colorectal surgeons and
others interested in this subject. The consensus on ideal reconstruction type
has not been achieved to date, although the number of papers on this subject
has been published in recent years. Objective. We conducted a prospective,
parallel group study comparing latero-terminal with colonic J-pouch
anastomosis in terms of defecatory function in patients undergoing stapled
low colorectal/ coloanal anastomosis. Methods. A total of 80 patients were
included in this study with either latero-terminal or colonic J-pouch
anastomosis. Defecatory function was evaluated using the modified version of
MSKCC questionnaire 6, 12 and 24 months after the operation. Fecal continence
was evaluated using the Wexner continence score. Results. In both groups,
trend towards improvement was registered in all measured variables in all
three control intervals. This can apply to bowel frequency, urgency, night
soiling, fragmentation and incomplete evacuation. However, the difference was
not statistically significant, and when reviewing the trend of results we can
note that in the J-pouch group steady state has not been reached even after
24 month control. Conclusion. 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 lateroterminal anastomosis.
J-pouch vs. side-to-end anastomosis after hand-assisted laparoscopic low anterior resection for rectal cancer: A prospective randomized trial on short and long term outcomes including life quality and functional results