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Indications for colonic J-pouch reconstruction after anterior resection for rectal cancer

Determining the optimum level of anastomosis

  • Original Contributions
  • Published:
Diseases of the Colon & Rectum

Abstract

PURPOSE: Functional outcome after anterior resection for rectal cancer is improved by colonic J-pouch reconstruction compared with straight anastomosis. The indications for colonic J-pouch reconstruction have yet to be determined. Therefore, we attempted to determine the level at which J-pouch reconstruction provides an advantage over straight anastomosis. METHODS: A total of 48 patients who underwent 5-cm colonic J-pouch reconstruction (J-pouch group) and 80 patients who underwent straight anastomosis (straight group) underwent functional assessment one year postoperatively. RESULTS: The functional outcome in the J-pouch group was significantly better than that in the straight group when the distance of the anastomosis from the anal verge was less than 8 cm. The difference was particularly obvious when the level of the anastomosis was below 4 cm. However, functional outcome in the straight group when the anastomosis was between 9 and 12 cm from the anal verge was also satisfactory and did not differ from that in the J-pouch group when the anastomosis was between 5 and 8 cm from the anal verge. CONCLUSIONS: Colonic J-pouch reconstruction is indicated when the distance of anastomosis from the anal verge is less than 8 cm, and it is essential when the distance is less than 4 cm.

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Authors and Affiliations

  1. First Department of Surgery, Kinki University School of Medicine, 377-2, Ohno-Higashi, Osaka-Sayama, 589-8511, Osaka, Japan

    Jin-ichi Hida M.D., Masayuki Yasutomi M.D., Takamasa Maruyama M.D., Kiyoshige Fujimoto M.D., Akihiro Nakajima M.D., Toshihiro Uchida M.D., Tsukasa Wakano M.D., Tadao Tokoro M.D., Ryuichi Kubo M.D. & Katsuhisa Shindo M.D.

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  1. Jin-ichi Hida M.D.
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  2. Masayuki Yasutomi M.D.
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  3. Takamasa Maruyama M.D.
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  4. Kiyoshige Fujimoto M.D.
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  5. Akihiro Nakajima M.D.
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  6. Toshihiro Uchida M.D.
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  7. Tsukasa Wakano M.D.
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  8. Tadao Tokoro M.D.
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  9. Ryuichi Kubo M.D.
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  10. Katsuhisa Shindo M.D.
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Additional information

Supported in part by a Grant-in-Aid for Scientific Research from the Japanese Ministry of Education, Culture, and Science and a Grant-in-Aid for Cancer Research from the Japanese Ministry of Health and Welfare.

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Hida, Ji., Yasutomi, M., Maruyama, T. et al. Indications for colonic J-pouch reconstruction after anterior resection for rectal cancer. Dis Colon Rectum 41, 558–563 (1998). https://doi.org/10.1007/BF02235260

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