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Scintigraphic comparison of neorectal emptying between colonic J-pouch anastomosis and straight anastomosis after stapled low anterior resection

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Abstract

Background and aims

Colonic J-pouch anastomosis after low anterior resection of the rectum has been reported to be associated with an increased risk of evacuation difficulty. Using scintigraphy we compared neorectal emptying after stapled low anterior resection between colonic J-pouch anastomosis and straight anastomosis.

Patients and methods

We studied 19 patients after colonic J-pouch anastomosis and 22 after straight anastomosis. After the introduction of an artificial stool containing 99mTc-DTPA into the neorectum sequential lateral gamma images were obtained. From the time activity curve of radioactivity in the whole pelvis the time taken to evacuate one-half of the introduced artificial stool (t 1/2) and the percentage of artificial stool evacuated in 1 min (Evac1) were calculated. Fourteen volunteers were also studied as the reference group.

Results

The t 1/2 was significantly longer and Evac1 significantly lower in patients after low anterior resection than in the reference group. t 1/2 was significantly longer in the pouch group than in the straight group. Anastomotic height was significantly correlated with both t 1/2 and Evac1. Neither t 1/2 nor Evac1 was correlated with the severity of impaired defecatory function.

Conclusion

Although neither of the two parameters of neorectal emptying was correlated with the severity of impaired defecatory function, less effective neorectal emptying in patients after colonic J-pouch anastomosis than in those after straight anastomosis may be a factor causing evacuation difficulty after colonic J-pouch anastomosis.

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Acknowledgements

We gratefully acknowledge Mr. Satoshi Natsui for his technical assistance with the scintigraphic assessment. This work was carried out at the Department of Surgery, Koshigaya Hospital, Dokkyo University School of Medicine without any financial assistance.

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Authors and Affiliations

  1. Department of Surgery, Koshigaya Hospital, Dokkyo University School of Medicine, 2-1-50 Minami-Koshigaya, 343-8555, Saitama, Japan

    Yoshitake Sugamata & Yasuo Takase

  2. Department of Surgery, Cancer Institute Hospital, 1-37-1 Kmi-Ikebukuro, Toshima-ku, 170-8455, Tokyo, Japan

    Masatoshi Oya

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  1. Yoshitake Sugamata
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  2. Yasuo Takase
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  3. Masatoshi Oya
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Correspondence to Masatoshi Oya.

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Sugamata, Y., Takase, Y. & Oya, M. Scintigraphic comparison of neorectal emptying between colonic J-pouch anastomosis and straight anastomosis after stapled low anterior resection. Int J Colorectal Dis 18, 355–360 (2003). https://doi.org/10.1007/s00384-003-0481-4

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