A novel colon pouch and its comparison with a straight coloanal and colon J-pouch anal anastomosis: Preliminary results in pigs

Background. Early functional results after complete rectal resection and st raight coloanal anastomosis are often characterized by frequent bowel movem ents, urgency, and: varying degrees of stool incontinence. The formation of a colon reservoir improves early and long-term-function, We evaluated the feasibility of a novel, modified design of a colon pouch-anal anastomosis i n pigs and compared the results with those of pigs with straight coloanal a nastomosis and colon J-pouch. Methods. Complete rectal resection followed by either a straight coloanal a nastomosis, a colon J-pouch, or a novel design of a colon pouch was perform ed in Equal numbers in 15 pigs. By transversely closing a longitudinal colo tomy, the new, technically simpler pouch is formed. Functional results were assessed during a period of 6 weeks. Results. All IT procedures were successful. The novel colon pouch required less surgical time than the colon J-pouch, and the formation of the pouches did not reduce tissue perfusion as assessed by laser Doppler flowmetry. Th e mean volume of the novel colon pouch was significantly smaller than the v olume of the colon J-pouch. All the pigs with the novel colon pouch had nor mal stool frequency and consistency during a period of 6 weeks. In the grou p with straight coloanal anastomosis, two pigs had increased frequency of d efecation, one pig showed signs of urgency and perianal dermatitis, and thr ee had substantially reduced stool consistency. Of the four pigs with colon J-pouch, three had signs of impaired pouch evacuation and two had reduced stool frequency. Conclusions. The novel colon pouch is feasible in pigs and technically simp ler than the colon J-pouch. These preliminary results indicate that the sma ller capacity of this pouch seems sufficient for normal defecation. Its sho rt-term functional results were better than those after reconstruction with a colon J-pouch or a straight coloanal anastomosis.