Abstract
This is the first documented case report in which construction of double pouches, a colonic J-pouch and a Mainz pouch with anastomosis to the urethra, was performed in a patient who underwent supralevator pelvic exenteration. We have shown that the operation is feasible; the patient was continent, except for nightly urinary leakage, and was able to defecate and urinate spontaneously without any catheterization. Based on the experience of this case, we believe that this combined operation results in a better quality of life for the patient because of the avoidance of both urinary and fecal stomas. If justified pathologically, this operation may represent an improvement for those patients with extensive cancer of the rectum, which invades the adjacent anterior viscera, or that of the bladder, which invades the posterior viscera.
Similar content being viewed by others
References
Parc R, Tiret E, Frileux P, Moszkowski E, Loygue J. Resection and colo-anal anastomosis with colonic reservoir for rectal carcinoma. Br J Surg 1986;73:139–41.
Thüroff JW, Alken P, Riedmiller H, Jacobi GH, Hohenfellner R. 100 cases of Mainz pouch: continuing experience and evolution. J Urol 1988;140:283–8.
Jakobsen H, Steven K, Stigsby B, Klarskov P, Hald T. Pathogenesis of nocturnal urinary incontinence after ileo-caecal bladder replacement: continuous measurement of urethral closure pressure during sleep. Br J Urol 1987;59:148–52.
Studer UE, Zingg EJ. Internal urinary diversion with a low pressure reservoir after radical cystoprostatectomy. J Urol 1987;137:206A.
Parks AG. Transanal technique in low rectal anastomosis. J R Soc Med 1972;65:975–6.
Parks AG, Percy JP. Resection and sutured colo-anal anastomosis for rectal carcinoma. Br J Surg 1982;69:301–4.
Lazorthes F, Fages P, Chiotasso P, Lemozy J, Bloom E. Resection of the rectum with construction of a colonic reservoir and colo-anal anastomosis for carcinoma of the rectum. Br J Surg 1986;73:136–8.
Nicholls RJ, Lubowski DZ, Donaldson DR. Comparison of colonic reservoir and straight colo-anal reconstruction after rectal excision. Br J Surg 1988;75:318–20.
Drake DB, Pemberton JH, Beart RW Jr, Dozois RR, Wolff BG. Coloanal anastomosis in the management of benign and malignant rectal disease. Ann Surg 1987;206:600–5.
Author information
Authors and Affiliations
About this article
Cite this article
Hatakeyama, K., Muto, T., Nishiyama, T. et al. Supralevator pelvic exenteration with colonic J-pouch-anal anastomosis and mainz pouch operation with anastomosis to the urethra. Dis Colon Rectum 34, 1131–1134 (1991). https://doi.org/10.1007/BF02050078
Issue Date:
DOI: https://doi.org/10.1007/BF02050078