ABSTRACT
There are ~40,000 new rectal cancer cases diagnosed each year in the United States,
representing the second most common gastrointestinal malignancy (behind colon cancer).
With the advent of sphincter preserving techniques, patients with mid and low colorectal
cancers enjoy the benefits of better postoperative functional outcomes and quality
of life; however, controversy exists over which reconstructive technique is superior
in restoring bowel continuity. Construction of a straight coloanal anastomosis is
technically simpler, but functional outcomes are inferior compared with colonic reservoirs.
The purpose of this review is to summarize the current data regarding reconstructive
techniques following proctectomy.
KEYWORDS
Rectal neoplasms - colonic pouches - proctocolectomy - restorative - anastomosis -
surgical
REFERENCES
- 1 American Cancer Society .Cancer Facts and Figures 2006. Atlanta, GA; American Cancer
Society 2006 Available at: http://www.cancer.org/downloads/STT/CAFF2006PWSecured.pdf Accessed January 11, 2006
- 2
Bernold D M, Sinicrope F A.
Advances in chemotherapy for colorectal cancer.
Clin Gastroenterol Hepatol.
2006;
4
808-821
- 3
Ortholan C, Francois E, Thomas O et al..
Role of radiotherapy with surgery for T3 and resectable T4 rectal cancer: evidence
from randomized trials.
Dis Colon Rectum.
2006;
49
302-310
- 4
Chessin D B, Guillem J G.
Surgical issues in rectal cancer: a 2004 update.
Clin Colorectal Cancer.
2004;
4
233-240
- 5
McNamara D A, Parc R.
Methods and results of sphincter-preserving surgery for rectal cancer.
Cancer Control.
2003;
10
212-218
- 6
Williams N, Seow-Choen F.
Physiological and functional outcome following ultra-low anterior resection with colon
pouch-anal anastomosis.
Br J Surg.
1998;
85
1029-1035
- 7
Chew S B, Tindal D S.
Colonic J-pouch as a neorectum: functional assessment.
Aust N Z J Surg.
1997;
67
607-610
- 8
Harris G J, Lavery I J, Fazio V W.
Reasons for failure to construct the colonic J-pouch. What can be done to improve
the size of the neorectal reservoir should it occur?.
Dis Colon Rectum.
2002;
45
1304-1308
- 9
Z'graggen K, Maurer C A, Birrer S, Giachino D, Kern B, Buchler M W.
A new surgical concept for rectal replacement after low anterior resection: the transverse
coloplasty pouch.
Ann Surg.
2001;
234
780-785
- 10
Lazorthes F, Chiotasso P, Gamagami R A, Istvan G, Chevreau P.
Late clinical outcome in a randomized prospective comparison of colonic J pouch and
straight coloanal anastomosis.
Br J Surg.
1997;
84
1449-1451
- 11
Barrier A, Martel P, Gallot D, Dugue L, Sezeur A, Malafosse M.
Long-term functional results of colonic J pouch versus straight coloanal anastomosis.
Br J Surg.
1999;
86
1176-1179
- 12
Ulrich A, Z'graggen K, Schmitz-Winnenthal H, Weitz J, Buchler M W.
The transverse coloplasty pouch.
Langenbecks Arch Surg.
2005;
390
355-360
- 13
McGinn F P, Gartell P C, Clifford P C, Brunton F J.
Staples or sutures for low colorectal anastomoses: a prospective randomized trial.
Br J Surg.
1985;
72
603-605
- 14
Everett W G, Friend P J, Forty J.
Comparison of stapling and hand-suture for left-sided large bowel anastomosis.
Br J Surg.
1986;
73
345-348
- 15
West of Scotland and Highland Anastomosis Study Group .
Suturing or stapling in gastrointestinal surgery: a prospective randomized study.
Br J Surg.
1991;
78
337-341
- 16
Docherty J G, McGregor J R, Akyol A M, Murray G D, Galloway D J.
Comparison of manually constructed and stapled anastomoses in colorectal surgery.
West of Scotland and Highland Anastomosis Study Group.
Ann Surg.
1995;
221
176-184
- 17
MacRae H M, McLeod R S.
Handsewn vs. stapled anastomoses in colon and rectal surgery: a meta-analysis.
Dis Colon Rectum.
1998;
41
180-189
- 18
Lustosa S A, Matos D, Atallah A N, Castro A A.
Stapled versus handsewn methods for colorectal anastomosis surgery.
Cochrane Database of Systematic Reviews.
2001;
(3)
, CD003144
- 19
Miller K, Moritz E.
Circular stapling techniques for low anterior resection of rectal carcinoma.
Hepatogastroenterology.
1996;
43
823-831
- 20
Vignali A, Fazio V W, Lavery I C et al..
Factors associated with the occurrence of leaks in stapled rectal anastomoses: a review
of 1,014 patients.
J Am Coll Surg.
1997;
185
105-113
- 21
Matthiessen P, Hallbook O, Andersson M, Rutegard J, Sjodahl R.
Risk factors for anastomotic leakage after anterior resection of the rectum.
Colorectal Dis.
2004;
6
462-469
- 22
Konishi T, Watanabe T, Kishimoto J, Nagawa H.
Risk factors for anastomotic leakage after surgery for colorectal cancer: results
of prospective surveillance.
J Am Coll Surg.
2006;
202
439-444
- 23
Beard J D, Nicholson M L, Sayers R D, Lloyd D, Everson N W.
Intraoperative air testing of colorectal anastomoses: a prospective, randomized trial.
Br J Surg.
1990;
77
1095-1097
- 24
Davies A H, Bartolo D C, Richards A E, Johnson C D, McC Mortensen N J.
Intra-operative air testing: an audit on rectal anastomosis.
Ann R Coll Surg Engl.
1988;
70
345-347
- 25
Karanjia N D, Corder A P, Holdsworth P J, Heald R J.
Risk of peritonitis and fatal septicaemia and the need to defunction the low anastomosis.
Br J Surg.
1991;
78
196-198
- 26
Dehni N, Schlegel R D, Cunningham C, Guiguet M, Tiret E, Parc R.
Influence of a defunctioning stoma on leakage rates after low colorectal anastomosis
and colonic J pouch-anal anastomosis.
Br J Surg.
1998;
85
1114-1117
- 27
Giuliani D, Willemsen P, Van Elst F, Vanderveken M.
A defunctioning stoma in the treatment of lower third rectal carcinoma.
Acta Chir Belg.
2006;
106
40-43
- 28
Machado M, Hallbook O, Goldman S, Nystrom P O, Jarhult J, Sjodahl R.
Defunctioning stoma in low anterior resection with colonic pouch for rectal cancer:
a comparison between two hospitals with a different policy.
Dis Colon Rectum.
2002;
45
940-945
- 29
Mealy K, Burke P, Hyland J.
Anterior resection without a defunctioning colostomy: questions of safety.
Br J Surg.
1992;
79
305-307
- 30
Pakkastie T E, Ovaska J T, Pekkala E S, Luukkonen P E, Jarvinen H J.
A randomised study of colostomies in low colorectal anastomoses.
Eur J Surg.
1997;
163
929-933
- 31
Graffner H, Fredlund P, Olsson S A, Oscarson J, Petersson B G.
Protective colostomy in low anterior resection of the rectum using the EEA stapling
instrument. A randomized study.
Dis Colon Rectum.
1983;
26
87-90
- 32
Wong N Y, Eu K W.
A defunctioning ileostomy does not prevent clinical anastomotic leak after a low anterior
resection: a prospective, comparative study.
Dis Colon Rectum.
2005;
48
2076-2079
- 33
Grabham J A, Moran B J, Lane R H.
Defunctioning colostomy for low anterior resection: a selective approach.
Br J Surg.
1995;
82
1331-1332
- 34
Rullier E, Laurent C, Garrelon J L, Michel P, Saric J, Parneix M.
Risk factors for anastomotic leakage after resection of rectal cancer.
Br J Surg.
1998;
85
355-358
- 35
Koperna T.
Cost-effectiveness of defunctioning stomas in low anterior resections for rectal cancer:
a call for benchmarking.
Arch Surg.
2003;
138
1334-1338
- 36
Nathanson D R, Espat N J, Nash G M et al..
Evaluation of preoperative and postoperative radiotherapy on long-term functional
results of straight coloanal anastomosis.
Dis Colon Rectum.
2003;
46
888-894
- 37
Joo J S, Latulippe J F, Alabaz O, Weiss E G, Nogueras J J, Wexner S D.
Long-term functional evaluation of straight coloanal anastomosis and colonic J-pouch:
is the functional superiority of the colonic J-pouch sustained?.
Dis Colon Rectum.
1998;
41
740-746
- 38
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
136-138
- 39
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
139-141
- 40
Hida J, Yasutomi M, Maruyama T et al..
Indications for colonic J-pouch reconstruction after anterior resection for rectal
cancer: determining the optimum level of anastomosis.
Dis Colon Rectum.
1998;
41
558-563
- 41
Seow-Choen F, Goh H S.
Prospective randomized trial comparing J colonic pouch-anal anastomosis and straight
coloanal reconstruction.
Br J Surg.
1995;
82
608-610
- 42
Hallbook O, Pahlman L, Krog M, Wexner S D, Sjodahl R.
Randomized comparison of straight and colonic J pouch anastomosis after low anterior
resection.
Ann Surg.
1996;
224
58-65
- 43
Banerjee A K, Parc R.
Prediction of optimum dimensions of colonic pouch reservoir.
Dis Colon Rectum.
1996;
39
1293-1295
- 44
Lazorthes F, Gamagami R, Chiotasso P, Istvan G, Muhammad S.
Prospective, randomized study comparing clinical results between small and large colonic
J-pouch following coloanal anastomosis.
Dis Colon Rectum.
1997;
40
1409-1413
- 45
Hida J, Yasutomi M, Fujimoto K et al..
Functional outcome after low anterior resection with low anastomosis for rectal cancer
using the colonic J-pouch. Prospective randomized study for determination of optimum
pouch size.
Dis Colon Rectum.
1996;
39
986-991
- 46
Hida J, Yasutomi M, Maruyama T, Tokoro T, Wakano T, Uchida T.
Enlargement of colonic pouch after proctectomy and coloanal anastomosis: potential
cause for evacuation difficulty.
Dis Colon Rectum.
1999;
42
1181-1188
- 47
Amin A I, Hallbook O, Lee A J, Sexton R, Moran B J, Heald R J.
A 5-cm colonic J pouch colo-anal reconstruction following anterior resection for low
rectal cancer results in acceptable evacuation and continence in the long term.
Colorectal Dis.
2003;
5
33-37
- 48
Braga M, Vignali A, Zuliani W et al..
Metabolic and functional results after laparoscopic colorectal surgery: a randomised,
controlled trial.
Dis Colon Rectum.
2002;
45
1070-1077
- 49
Pikarsky A J, Rosenthal R, Weiss E G, Wexner S D.
Laparoscopic total mesorectal excision.
Surg Endosc.
2002;
16
558-562
- 50
Breukink S, Pierie J, Wiggers T.
Laparoscopic versus open total mesorectal excision for rectal cancer.
Cochrane Database Syst Rev.
2006;
4
CD005200
- 51
Chung C C, Ha J P, Tsang W W, Li M K.
Laparoscopic-assisted total mesorectal excision and colonic J pouch reconstruction
in the treatment of rectal cancer.
Surg Endosc.
2001;
15
1098-1101
- 52
Tsang W W, Chung C C, Kwok S Y, Li M K.
Laparoscopic sphincter-preserving total mesorectal excision with colonic J-pouch reconstruction:
five-year results.
Ann Surg.
2006;
243
353-358
- 53
Heriot A G, Tekkis P P, Constantinides V et al..
Meta-analysis of colonic reservoirs versus straight coloanal anastomosis after anterior
resection.
Br J Surg.
2006;
93
19-32
- 54
Koh P K, Tang C L, Eu K W, Samuel M, Chan E.
A systematic review of the function and complications of colonic pouches.
Int J Colorectal Dis.
2007;
22(5)
543-548
- 55
Sailer M, Fuchs K H, Fein M, Thiede A.
Randomized clinical trial comparing quality of life after straight and pouch coloanal
reconstruction.
Br J Surg.
2002;
89
1108-1117
- 56
Ho Y H, Seow-Choen F, Tan M.
Colonic J-pouch function at six months versus straight coloanal anastomosis at two
years: randomized controlled trial.
World J Surg.
2001;
25
876-881
- 57
Ho Y H, Brown S, Heah S M et al..
Comparison of J-pouch and coloplasty pouch for low rectal cancers; a randomized controlled
trial investigating functional results and anastomotic leak rates.
Ann Surg.
2002;
236
49-55
- 58
Furst A, Suttner S, Agha A, Beham A, Jauch K W.
Colonic J-pouch vs coloplasty following resection of distal rectal cancer: early results
of a prospective, randomized, pilot study.
Dis Colon Rectum.
2003;
46
1161-1166
- 59
Furst A, Burghofer K, Hutzel L, Jauch K-W.
Neorectal reservoir is not the functional principle of the colonic J-pouch: the volume
of a short colonic J-pouch does not differ from a straight coloanal anastomosis.
Dis Colon Rectum.
2002;
45
660-667
- 60
Pimentel J M, Duarte A, Gregorio C, Souto P, Patricio J.
Transverse coloplasty pouch and colonic J-pouch for rectal cancer - a comparative
study.
Colorectal Dis.
2003;
5
465-470
- 61
Oya M, Komatsu J, Takase Y, Nakamura T, Ishikawa H.
Comparison of defecatory function after colonic J-pouch anastomosis and straight anastomosis
for stapled low anterior resection: results of a prospective randomized trial.
Surg Today.
2002;
32
104-110
- 62
Z'graggen K, Maurer C A, Mettler D, Stoupis C, Wildi S, Buchler M W.
A novel colon pouch and its comparison with a straight coloanal and colon J-pouch-anal
anastomosis: preliminary results in pigs.
Surgery.
1999;
125
105-112
- 63
Fazio V W, Mantyh C R, Hull T L.
Colonic “coloplasty”: novel technique to enhance low colorectal or coloanal anastomosis.
Dis Colon Rectum.
2000;
43
1448-1450
- 64
Mantyh C R, Hull T L, Fazio V W.
Coloplasty in low colorectal anastomosis: manometric and functional comparison with
straight and colonic J-pouch anastomosis.
Dis Colon Rectum.
2001;
44
37-42
- 65
Ulrich A, Z'graggen K, Weitz J, Buchler M W.
Functional results of the colon J-pouch versus transverse coloplasty pouch in Heidelberg.
Recent Results Cancer Res.
2005;
165
205-211
- 66
Maurer C A, Z'graggen K, Zimmermann W, Hani H J, Mettler D, Buchler M W.
Experimental study of neorectal physiology after formation of a transverse coloplasty
pouch.
Br J Surg.
1999;
86
1451-1458
- 67
Kanne V, Kim N H, Ulrich B.
The Transverse Coloplasty Pouch (TCP)-function and subjective judgement in comparison
with the surgically more complicated J-Pouch.
Zentralbl Chir.
2002;
127
781-785
- 68
Brown C J, Fenech D S, McLeod R S.
Straight coloanal anastomosis, colonic J pouch or transverse coloplasty for reconstruction
after rectal resection for rectal cancer.
Cochrane Colorectal Cancer Group Cochrane Database of Systematic Reviews.
2007;
(2)
, CD006040
Christopher R MantyhM.D.
DUMC, P.O. Box 3117
Durham, NC 27710
Email: manty001@mc.duke.edu