COLONIC J-POUCH RECTAL RECONSTRUCTION - IS IT REALLY A NEORECTUM

PURPOSE: The aim of this study was to determine whether a colonic J-po uch has similar properties to that of a normal rectum, including recov ery of rectoanal coordination. METHODS: Ten patients with colonic J-po uch-anal anastomosis (anastomotic distance from anal verge, 3.5 (range , 2.0-4.5) cm for low rectal cancer (7 men; mean age, 64.7 (range, 44- 76) years) were studied clinically and in the anorectal physiology lab oratory at least one year after operation. Results were compared with a series of ten matched patients who underwent high anterior resection for upper rectal carcinoma (anastomotic height, 12.7 (range, 9.5-16) cm). RESULTS: Although results seemed to be slightly better in the gro up with the rectum preserved, no statistical differences could be foun d either in functional outcome or anorectal physiology. One-half of th e patients with colonic J-pouch (neorectum) had a positive rectoanal i nhibitor)y reflex. CONCLUSION: Addition of a colon pouch neorectum wou ld appear to improve function to the level of those patients with a hi gh anastomosis and ''normal'' rectum.