Meta-analysis of colonic reservoirs versus straight coloanal anastomosis after anterior resection

Abstract

The colonic J-pouch provided functional benefits over straight anastomosis with no increase in postoperative complications. Coloplasty appeared to have similar benefits but further studies are required for validation.

Aspectos fisiopatológicos da síndrome pós-ressecção anterior do reto para o tratamento de câncer retal

“…In spite of techniques to increase the volume of the "new rectum", such as latero-terminal anastomosis and J pouch of distal colon, the functional advantages in relation to direct anastomosis are only transient in the first 24 months 11,17,18 . Some studies suggest that intestinal dysfunction would be more related to increased colonic motility than to the type of anastomosis.…”

Complete laparoscopic total mesorectal excision with an intersphincteric resection and coloplasty pouch anal anastomosis for lower rectal cancer

“…However, poor bowel function may be expected with straight CAA because the reservoir function of the excised rectum is lost and some damage to the anal sphincters are induced when preoperative chemoradiotherapy (CRT) and/or intersphincteric resection (ISR) was performed 3) . In such circumstances, restoration of the rectal reservoir by creation of a colonic J-pouch or performance of coloplasty pouch improved early bowel function 3) . Laparoscopic surgery is now widely used for the treatment of low rectal cancer 4) .…”

Colonic Reservoirs in Patients After Rectal Resection

“…Results of oncological treatment in both groups are similar (29). Although researchers are unanimous in the evaluation of the quality of life of the patients, there is a dominant opinion that within a year from the opening of the anal passage, benefits are observed in patients with a fecal reservoir (17,25,27,29,30,38). This is important for patients with only a short expected survival (57).…”

“…1a). A JP reservoir allows achievement of an optimum treatment outcome and improves the patient's quality of life, particularly within one to two years following the surgery, as compared with patients without reservoirs (10,(25)(26)(27)(28)(29)(30). The technique used to produce a JP reservoir is in fact copied from the technique used to construct small-intestine reservoirs that was applied by Utsonomija et al in the 1970s (31).…”

“…This is important for patients with only a short expected survival (57). Although after the first year the benefits of this procedure seem to be less clear, most authors believe benefits extend up to two, three, five and more years of observation (17,27,28,29,40,58,59). The range of the observed benefits varies.…”