Physiological and functional outcome following ultra-low anterior resection with colon pouch-anal anastomosis

• Published in: British journal of surgery Vol. 85; no. 8; pp. 1029 - 1035
• Main Authors: Williams, N., Seow-Choen, F.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.08.1998; Wiley
• Subjects: Anal Canal - surgery; Anastomosis, Surgical; Biological and medical sciences; Colon - surgery; Defecation - physiology; Humans; Medical sciences; Proctocolectomy, Restorative - methods; Rectal Neoplasms - physiopathology; Rectal Neoplasms - surgery; Stomach, duodenum, intestine, rectum, anus; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Surgical Wound Dehiscence - etiology; Human; Rectal disease; Anastomosis; Review; Abdominoperineal resection; Association; Anus; Anterior resection; Surgery; Rectum; Running; Marsupialization; Digestive diseases; Physiology; Colon; Comparative study
• ISSN: 0007-1323; 1365-2168
• DOI: 10.1046/j.1365-2168.1998.00804.x

Background Low rectal cancer is usually managed by ultra‐low anterior resection (ULAR) with total mesorectal excision and straight coloanal anastomosis. However, following this procedure patients often suffer from frequency, urgency of bowel action and, occasionally, faecal incontinence. To overcome such problems, a colon pouch may be fashioned and a subsequent colon pouch–anal anastomosis performed. The physiological and functional outcome following the use of a colon pouch are appraised. Methods All relevant papers identified from a Medline search and papers from cross‐referencing were reviewed. Results and Conclusion Creation of a colon pouch following ULAR results in reduced bowel frequency, and a lower incidence of urgency and faecal incontinence. Although there is a slightly increased incidence of evacuatory disorder and need for enemas or suppositories, this appears to be a minor problem which may possibly be overcome by using a smaller colon pouch. Compared with straight coloanal anastomosis following ULAR, the creation of a colon pouch produced a superior functional outcome. © 1998 British Journal of Surgery Society Ltd