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Safety and morbidity after ultra-low coloanal anastomoses: J-pouch vs end-to-end reconstruction

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background and aims

Anastomotic failure after ultra-low anterior rectum resection is the most important complication, and it is influenced by the type of reconstruction. The aim of this study was to compare retrospectively the straight coloanal anastomosis with the J-pouch reconstruction concerning the development of anastomotic leakage.

Materials and methods

Fifty-six of 381 consecutive patients underwent low anterior rectum resection with total mesorectal excision and ultra-low coloanal anastomosis at 3–4 cm from the anocutan line. A 5-cm J-pouch (side-to-end) was performed in 25, a straight coloanal anastomosis in 25, and a coloplasty in 6 patients, respectively.

Results/findings

No influence by age, body mass index, and operating time on anastomotic leakage rate was found. Leakage was found in eight patients with straight coloanal anastomosis, resulting in a leakage rate of 32% compared to one patient in the J-pouch group (P = 0.023).

Interpretation/conclusion

Patient’s safety is higher after J-pouch reconstruction because of the lower anastomotic failure rate, and functional results had been reported as similar after J-pouch reconstruction and straight coloanal anastomosis. Therefore, we clearly argue for a J-pouch reconstruction as the standard method after ultra-low coloanal anastomosis.

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Authors and Affiliations

  1. Department of Surgery, Cantonal Hospital of St. Gallen, CH-9007, St. Gallen, Switzerland

    Thomas Steffen, Ignazio Tarantino, Franc Heinrich Hetzer, René Warschkow, Jochen Lange & Michael Zünd

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  1. Thomas Steffen
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  2. Ignazio Tarantino
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  3. Franc Heinrich Hetzer
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  4. René Warschkow
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  5. Jochen Lange
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  6. Michael Zünd
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Correspondence to Thomas Steffen.

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Steffen, T., Tarantino, I., Hetzer, F.H. et al. Safety and morbidity after ultra-low coloanal anastomoses: J-pouch vs end-to-end reconstruction. Int J Colorectal Dis 23, 277–281 (2008). https://doi.org/10.1007/s00384-007-0414-8

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  • DOI: https://doi.org/10.1007/s00384-007-0414-8

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