The transverse coloplasty pouch. Review of experimental data and clinical application
Summary
The transverse coloplasty pouch is a novel technique for sphincter preserving colonic reconstruction after total mesorectal excision. The method was developed in an animal model and resulted in favorable early functional results. Our results in patients with rectal cancer demonstrate that the technique is technically easy and safe. The transverse coloplasty pouch provides a neorectal reservoir of adequate volume and a favorable early functional outcome. It leads to a reduction in stool frequency compared with a straight anastomosis and the outcome is comparable to other colon reservoirs.
Zusammenfassung
Der transverse Koloplastikpouch ist eine neuartige Methode der sphinktererhaltenden Rekonstruktion nach Total Mesorektaler Exzision. Die Methode wurde zuerst im Tiermodell entwickelt und erzielte funktionell gute Resultate. Die bisherigen Resultate beim Menschen zeigen, dass der transverse Koloplastikpouch technisch einfach und sicher anzuwenden ist. Sowohl frühfunktionell, wie auch im mittelfristigen Verlauf bis ein Jahr postoperativ ergeben sich günstige Resultate mit einer Reduktion der Stuhlfrequenz im Vergleich zur geraden Anastomose ohne Reservoirbildung. Aufgrund unserer Erfahrung sind die funktionellen Resultate vergleichbar mit denjenigen nach Kolon J-Reservoir.
Key words
Transverse coloplasty - colon pouch - rectal cancer - sphincter preservation - total mesorectal excision
Schlüsselwörter
Transverse Koloplastik - Kolonpouch - Rektumkarzinom - Kontinenzerhaltung - Total Mesorektale Exzision
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Priv.-Doz. Dr. Kaspar Z'graggen
Klinik für Viszerale und Transplantationschirurgie Universität Bern Inselspital
CH-3010 Bern
Telefon: 00 41/31/6 32 85 15
Fax: 00 41/31/6 32 83 34
eMail: kaspar.zgraggen@insel.ch