Some surgeons prefer to fashion a colonic pouch after TME to improve the functional outcome. However, there are concerns that in the long-term the pouch dilates and results in poor function. What are your experiences/opinions in this regard?
No significant improvement is related to colonic pouch. After 6 months - 1 year no difference can be detected in T-T anastomosis Vs Colonic pouch group about functional outcomes (n. of defecations per day, bowel habits).
We perform a end-to-side descendo-rectostomy. after 1 year the results are the same
A couple of years ago, I used the Bern pouch in its revised form (not the original published version, because of high leak rates). But I did not see any advantage, and so I dismissed it again. Short term outcomes were not better and longterm results did not demonstrate any difference.
Straight coloanal anastomosis may be related to higher evacuation frequency and the occurrence of fragmented evacuations, while colonic pouch is related to better functional results and more predictable evacuations in early evaluations. although long term evaluations show almost no difference between straight or pouch anastomosis, it must be considered that some patients will not have "long term" evaluation, which makes this issue important. this is why i always use J-pouch when I have to do a ultra-low rectum or anal canal anastomosis.
- Badges
- Science topic
- Similar topics
- Geoscience
- Asia
- India