Indications for colonic J-pouch reconstruction after anterior resection for rectal cancer - Determining the optimum level of anastomosis

被引:46
作者
Hida, J [1 ]
Yasutomi, M [1 ]
Maruyama, T [1 ]
Fujimoto, K [1 ]
Nakajima, A [1 ]
Uchida, T [1 ]
Wakano, T [1 ]
Tokoro, T [1 ]
Kubo, R [1 ]
Shindo, K [1 ]
机构
[1] Kinki Univ, Sch Med, Dept Surg 1, Osaka 5898511, Japan
关键词
anastomotic level; anterior resection; indications for colonic J-pouch reconstruction; rectal cancer;
D O I
10.1007/BF02235260
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
PURPOSE: Functional outcome after anterior resection for rectal cancer is improved by colonic J-pouch reconstruction compared with straight anastomosis. The indications for colonic J-pouch reconstruction have pet to be determined. Therefore, we attempted to determine the level at which J-pouch reconstruction provides an advantage over straight anastomosis. METHODS: A total of 48 patients who under went 5-cm colonic J-pouch reconstruction (J-pouch group) and 80 patients who underwent straight anastomosis (straight group) underwent functional assessment one year postoperatively. RESULTS: The functional outcome in the J-pouch group was significantly better than that in the straight group when the distance of the anastomosis from the anal verge was less than 8 cm. The difference was particularly obvious when the level of the anastomosis was below 4 cm. However, functional outcome in the straight group when the anastomosis was between 9 and 12 cm from the anal verge was also satisfactory and did not differ from that in the J-pouch group when the anastomosis was between 5 and 8 cm from the anal verge. CONCLUSIONS: Colonic J-pouch reconstruction is indicated when the distance of anastomosis from the anal verge is less than 8 cm, and it is essential when the distance is less than 4 cm.
引用
收藏
页码:558 / 563
页数:6
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