Abstract
The functional outcome after a low anterior resection for rectal cancer is improved by a colonic J-pouch reconstruction. One functional problem with J-pouches is difficulty in evacuation, which is more common with large reconstructions. Since rectoceles are common findings on defecography in patients with evacuation difficulties, we proposed that a rectocele-like prolapse may be thus found in patients with large J-pouches. Pouchography was used to identifya rectocele-like prolapse (RP) in 26 patients with a 10-cm J-pouch (10-J group) and 27 patients with a 5-cm J-pouch (5-J group). Pouchography was performed at 3 months, 1 year, and 2 years after surgery. Functional assessments were performed 1 year postoperatively. Clinical function was evaluated using a questionnaire. The evacuation function was evaluated by the balloon expulsion and saline evacuation test. No patients had an RP at 3 months or 1 year after surgery. An RP was significantly more common in the 10-J group than in the 5-J group at 2 years after surgery (P=0.0374). An evacuation difficulty was significantly more common in the 10-J group than in the 5-J group. The evacuation function in the 10-J group was also significantly inferior to that in the 5-J group. An RP appearing 2 years after surgery is more common in patients with evacuation difficulties and large colonic J-pouch reconstructions.
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This work was supported in part by a Grant-in-Aid for Scientific Research from the Japanese Ministry of Education, Culture and Science, and a grant for Cancer Research from the Osaka Cancer Foundation.
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Hida, JI., Yasutomi, M., Maruyama, T. et al. Detection of a rectocele-like prolapse in the colonic J-pouch using pouchography: Cause or effect of evacuation diffculties?. Surg Today 29, 1237–1242 (1999). https://doi.org/10.1007/BF02482214
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DOI: https://doi.org/10.1007/BF02482214