FUNCTIONAL RESULTS AFTER HIGH COLOANAL ANASTOMOSIS AND LOW COLOANAL ANASTOMOSIS WITH A COLONIC J-POUCH FOR RECTAL-CARCINOMA

The aim of this study was to determine the postoperative function of n eorectoanal components using two different types of very low coloanal reconstruction. The two groups of patients assessed were 22 who underw ent abdominal rectal resection and stapled ''high'' coloanal anastomos is without a pouch, being the HCAA-P group; and 34 who underwent anoab dominal rectal resection and ''low'' coloanal anastomosis with a colon ic J-pouch, being the LCAA+P group. Manometric examination was perform ed 1, 3, 6, and 12 months postoperatively, and the patients were also assessed by a questionnaire, The LCAA+P group had remarkably less dail y stool frequency and urgency, but there were no significant differenc es in the other functional parameters. Maximum resting pressure (MRP) was significantly less, while threshold volume (TV) and maximum tolera ble volume (MTV) were greater in the LCAA+P group than in the HCAA-P g roup, The colonic J-pouch compensated for decreased MRP. Thus, when HC AA-P is performed, 3.0 cm of residual rectum with internal anal sphinc ter may be required, and construction of the pelvic pouch is desirable in low coloanal anastomosis.