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Functional and physiologic assessment of the colonic reservoir or side-to-end anastomosis after low anterior resection for rectal cancer: a two-year follow-up
Centre of Gastrointestinal Disease, Ersta Hospital, Karolinska Institutet, Stockholm; Centre for Surgical Sciences, Karolinska University Hospital, Huddinge, Stockholm.
Centre of Gastrointestinal Disease, Ersta Hospital, Karolinska Institutet, Stockholm; Centre for Surgical Sciences, Karolinska University Hospital, Huddinge, Stockholm.
Centre of Gastrointestinal Disease, Ersta Hospital, Karolinska Institutet, Stockholm; Centre for Surgical Sciences, Karolinska University Hospital, Huddinge, Stockholm.
Centre of Gastrointestinal Disease, Ersta Hospital, Karolinska Institutet, Stockholm; Centre for Surgical Sciences, Karolinska University Hospital, Huddinge, Stockholm.ORCID iD: 0000-0003-2636-4745
2005 (English)In: Diseases of the Colon & Rectum, ISSN 0012-3706, E-ISSN 1530-0358, Vol. 48, no 1, p. 29-36Article in journal (Refereed) Published
Abstract [en]

Purpose: Functional disturbances are common after anterior resection for rectal cancer. This study was designed to compare functional and physiologic outcome after low anterior resection and total mesorectal excision with a colonic J-pouch or a side-to-end anastomosis.

Methods: Functional and physiologic variables were analyzed in patients randomized to a J-pouch (n = 36) or side-to-end anastomosis (n = 35). Postoperative functional outcome was investigated with questionnaires. Anorectal manometry was performed preoperatively and at six months, one year, and two years postoperatively.

Results: There was no statistical difference in functional outcome between groups at two years. Maximum neorectal volume increased in both groups but was approximately 40 percent greater at two years in pouches compared with the side-to-end anastomosis. Anal sphincter pressures volumes were halved postoperatively and did not recover during follow-up of two years. Male gender, low anastomotic level, pelvic sepsis, and the postoperative decrease of sphincter pressures were independent factors for more incontinence symptoms.

Conclusions: Colonic J-pouch and side-to-end anastomosis gives comparable functional results two years after low anterior resection. Neorectal volume had no detectable influence on function. There was a pronounced and sustained postoperative decrease in sphincter pressures.

Place, publisher, year, edition, pages
Philadelphia, USA: Lippincott Williams & Wilkins, 2005. Vol. 48, no 1, p. 29-36
Keywords [en]
Tectal cancer, long-term function, pouch, side-to-end anastomosis, prospective, randomized trial
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:oru:diva-40378DOI: 10.1007/s10350-004-0772-zISI: 000226058500005PubMedID: 15690654Scopus ID: 2-s2.0-13744260570OAI: oai:DiVA.org:oru-40378DiVA, id: diva2:777163
Available from: 2015-01-08 Created: 2015-01-08 Last updated: 2017-12-05Bibliographically approved

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