THE COLOANAL POUCH - INDICATION, FUNCTION AND RESULTS

Low anterior resection of rectal cancer with preservation of the anal sphincter has comparable recurrence and survival rates when compared t o abdominoperineal excision. Stool frequency and leakage rates are hig h after coloanal anastomosis. The colonic J-pouch improves function. E ndosonographic tumor stages ES T1 and ES T2 for cancer in the distal t hird rectum and ES T3 tumors in die middle third rectum are indication s for rectal resection with preservation of the sphincter and reconstr uction with the colonic pouch. In 33 patients the technique was safe, with no deaths and no reoperation. Three diverting colostomies are not yet closed. 25 patients are perfect continent, two are incontinent fo r gas, three have minor and one patient major incontinence. Only one p atient has more than three bowel movements in 24 hrs. For selected can cers of the distal half of the rectum total resection with preservatio n of the anal sphincter is a safe operation. Good function is provided by the colon J-pouch.