COLONIC POUCHES AFTER SURGERY FOR RECTAL CARCINOMA

Therev is little dout about the excellent early functional outcome obtained after colonic pouch analanastomosis . the
improvement in the functional outcome at 2 years following complete rectal excision with colonic J- pouch anal anastomosis has been frequently reported .
The aim of this to evaluate the clinical, the function and the oncologic results of low and ultralow anterior resection of
the rectum for carcinoma with or without creation of a pouch .
Forty patients in the Surgical Oncology Unit in Mansoura University Hospital , under low or ultralow anterior
resection for rectal carcinoma located between 4-11 cm from tge anal verge . twenty patients werw randomized for
restoration of cotinuity by coloanal anastomosis , and the remainig 20 patient underwent colonic J- pouch anal anastomosis.
All patirnt underwent a complete metastatic and oncologic workup , abdominal ultrasound , pelviabdominal CT , barium
studies and colonoscopy .
As regards the functional outcome , about 90% of the patient , with pouch were good continence but only 80% in the
othergroup . Uregency was 5% in the pouch group and 45% in the other group . Frequency of tool was 2- day and 4- day in both groups respectively. As regards the recurrence of the disease the creation of the pouch does not affect the oncologic results.
Colonic J- pouch anal anastomosis is an oncologically safe procedure and an optimum means of reconstruction after
rectal excision for carinoma of the low and mid rectum, if distal safety of at least 2-cm could be ascertained . The superior
functional outcome after colonic pouch anal anastomis could achieved and maintained.