Colonic J pouch neo‑rectum versus straight anastomosis for low rectal cancers.
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Date
2014-10
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Abstract
AIM: The development of sphincter saving procedures for low carcinoma rectum has been the consequence of oncological and technological
factors. The major disadvantage associated with these procedures is the development of anterior resection syndrome because of the resection of
rectal reservoir. Colonic J pouch (CJP) neorectum has been practiced as an antidote to overcome this problem. We are working at a tertiary care
center, which is a high volume center for rectal cancers. We thought it worthwhile to assess the efficacy of J Pouch neorectum viz.‑a‑viz. a straight
coloanal anastomosis for low rectal cancers. MATERIALS AND METHODS: Hospital based prospective randomized study (June 2007‑December
2009) low rectal cancers (4‑12 cm from the anal verge). One group (20 patients) subjected to low/ultralow anterior resection with straight
anastomosis (SA) and other group (22 patients) to CJP. The two groups were compared on the basis of functional outcome. RESULTS: Anastomotic
leak, strictures, frequency of bowel movements, nocturnal bowel movements, use of retarding medication and incontinence to solids, liquids
and gases were seen more in SA group. All these findings were statistically significant. CONCLUSIONS: We conclude that CJP has a significant
functional advantage over SA and improves the overall quality‑of‑life in patients of low rectal cancers and the advantage persisted over a period
of more than 30 months.
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Keywords
Anastomosis, colon cancer, colonic J pouch
Citation
Parray F Q, Farouqi U, Wani M L, Chowdri N A, Shaheen F. Colonic J pouch neo‑rectum versus straight anastomosis for low rectal cancers. Indian Journal of Cancer. 2014 Oct-Dec; 51(4): 560-564.