Function of a colonic J pouch continues to improve with time

Background: J pouch-anal anastomosis is thought to give superior functional results to straight coloanal anastomosis after rectal resection. Follow-up studies have suggested that this improvement is not maintained and that ev acuatory difficulties may increase. Methods: Some 119 consecutive patients had a coloanal anastomosis after res ection for rectal carcinoma over 113 months, 62 with a J pouch and 57 with a straight coloanal anastomosis. Functional results were determined by pati ent questionnaire. The two groups were compared for the first and second 5- year intervals of study. Results. Patients who had a J pouch had significantly better median Kirwan continence scores for the duration of the study and 5-9 years after surgery : 1 versus 2 (P = 0.05) and 1 versus 2 (P < 0.01), respectively. Some 5-9 y ears after surgery the median number of nocturnal bowel movements was signi ficantly lower in patients who had a J pouch than in those with a straight coloanal anastomosis (0 versus 1; P = 0.02). Similarly, significantly bette r results were seen with regard to evacuation difficulties and urgency of d efaecation. Conclusion: The function of the J pouch was superior to that of the straigh t coloanal anastomosis and appeared to improve with time.