LASER-DOPPLER BLOOD-FLOW MEASUREMENT IN RECTAL RESECTION FOR CARCINOMA - COMPARISON BETWEEN THE STRAIGHT AND COLONIC J-POUCH RECONSTRUCTION

Lower rates of anastomotic leakage have been reported after rectal res ection with a colonic pouch-anal anastomosis than with a conventional straight anastomosis. The microcirculation in the bowel segment that w as used for construction of a colonic pouch or a conventional straight anastomosis was examined, Transmural colonic blood flow was measured by laser Doppler flowmetry during the operation before the constructio n of a straight (n = 16) or pouch (n = 14) anastomosis. The blood flow recordings were first done before dissection of the bowel at one poin t close to the planned bowel end and at another point 8 cm more proxim ally. A second recording was done at the same sites after dissection a nd, where appropriate, after construction of the pouch, but before the anastomosis was completed. In the straight group (end-to-end anastomo sis), blood flow levels at the site intended for the anastomosis were significantly decreased following dissection of the bowel. In the pouc h group (side-to-end anastomosis), blood flow levels at the site of th e anastomosis were similar following dissection of the bowel and pouch construction. It is concluded that unaffected blood flow at the site of the anastomosis of the pouch may be a favourable factor for anastom otic healing.