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Similar outcome after colonic pouch and side-to-end anastomosis in low anterior resection for rectal cancer: a prospective randomized trial.
Centre of Gastrointestinal Disease, Ersta Hospital, Stockholm.
Centre of Gastrointestinal Disease, Ersta Hospital, Stockholm.
Centre of Gastrointestinal Disease, Ersta Hospital, Stockholm.
Centre of Gastrointestinal Disease, Ersta Hospital, Stockholm.ORCID iD: 0000-0003-2636-4745
2003 (English)In: Annals of Surgery, ISSN 0003-4932, E-ISSN 1528-1140, Vol. 238, no 2, p. 214-20Article in journal (Refereed) Published
Abstract [en]

Objectives: To compare a colonic J-pouch or a side-to-end anastomosis after low-anterior resection for rectal cancer with regard to functional and surgical outcome.

Summary beckground data: A complication after restorative rectal surgery with a straight anastomosis is low-anterior resection syndrome with a postoperatively deteriorated anorectal function. The colonic J-reservoir is sometimes used with the purpose of reducing these symptoms. An alternative method is to use a simple side-to-end anastomosis.

Methods: One-hundred patients with rectal cancer undergoing total mesorectal excision and colo-anal anastomosis were randomized to receive either a colonic pouch or a side-to-end anastomosis using the descending colon. Surgical results and complications were recorded. Patients were followed with a functional evaluation at 6 and 12 months postoperatively.

Results: Fifty patients were randomized to each group. Patient characteristics in both groups were very similar regarding age, gender, tumor level, and Dukes' stages. A large proportion of the patients received short-term preoperative radiotherapy (78%). There was no significant difference in surgical outcome between the 2 techniques with respect to anastomotic height (4 cm), perioperative blood loss (500 ml), hospital stay (11 days), postoperative complications, reoperations or pelvic sepsis rates. Comparing functional results in the 2 study groups, only the ability to evacuate the bowel in <15 minutes at 6 months reached a significant difference in favor of the pouch procedure.

Conclusions: The data from this study show that either a colonic J-pouch or a side-to-end anastomosis performed on the descending colon in low-anterior resection with total mesorectal excision are methods that can be used with similar expected functional and surgical results.

Place, publisher, year, edition, pages
Philadelphia, USA: Lippincott Williams & Wilkins, 2003. Vol. 238, no 2, p. 214-20
National Category
Medical and Health Sciences Surgery
Identifiers
URN: urn:nbn:se:oru:diva-40388DOI: 10.1097/01.sla.0000080824.10891.e1ISI: 000185835000009PubMedID: 12894014Scopus ID: 2-s2.0-0042914860OAI: oai:DiVA.org:oru-40388DiVA, id: diva2:777145
Available from: 2015-01-08 Created: 2015-01-08 Last updated: 2017-12-05Bibliographically approved

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