Functional results of colonic J-pouch anastomosis for rectal cancer

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.