Long-term functional results of colonic J pouch versus straight coloanal anastomosis

Br J Surg. 1999 Sep;86(9):1176-9. doi: 10.1046/j.1365-2168.1999.01224.x.

Abstract

Background: There are very few studies evaluating the long-term functional outcome of coloanal anastomoses. This retrospective study aimed to compare long-term functional results of straight and colonic J pouch anastomoses.

Methods: Thirty-seven patients, 25 with a straight anastomosis and 12 with a J pouch anastomosis, responded to a standardized telephone questionnaire. The mean time since surgery was 10 (range 4-18) years.

Results: The mean daily stool frequency was similar in both groups of patients (1.1 in patients with a reservoir, 1.5 in patients with a straight anastomosis). In both groups, two-thirds of patients had perfect continence or limited gas incontinence. Faecal incontinence was reported by two patients with a straight anastomosis and one patient with a pouch. Nocturnal stools and fragmentation were slightly more frequent in patients with a straight anastomosis. Half of the patients regularly used medication. Thirty-five of the 37 patients reported satisfaction with functional results.

Conclusion: Long-term functional results of coloanal anastomoses are satisfactory and, unlike early results, similar for both types of anastomosis. The functional benefit of a reservoir, seen in the first year after operation, is less evident with increasing time.

MeSH terms

  • Adult
  • Aged
  • Anal Canal / surgery
  • Anastomosis, Surgical / methods*
  • Antidiarrheals / therapeutic use
  • Cathartics / therapeutic use
  • Colon / surgery
  • Colonic Diseases / physiopathology*
  • Colonic Diseases / surgery
  • Defecation / physiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Proctocolectomy, Restorative*
  • Retrospective Studies

Substances

  • Antidiarrheals
  • Cathartics