Anterior resection of the rectum can be associated with disturbance of bowel function termed ‘anterior resection syndrome’. Many techniques to improve bowel function following surgery have been proposed and we present our experience of one of them: the colonic J pouch.
Eligible patients were identified, notes searched for key variables including disease type, disease stage if malignant and patient comorbidities. A bowel function questionnaire was sent to all eligible patients. The Mann–Whitney U test was used for statistical analysis.
Overall, 65 patients responded to the questionnaire. Demographics were not significantly different. When compared together, bowel frequency, medication use and incontinence symptoms were significantly improved in the straight anastomosis (p = 0.016, 0.004 and 0.046 respectively). When subdivided by time postoperatively (≤ 5 years and ≥ 6 years), only medication use retained significance (p = 0.044, 0.037 respectively). No evacuatory difficulties were seen in the pouch group. More patients in the pouch group received neoadjuvant chemoradiotherapy (5.7 vs 63.3 %).
Our results seem to indicate better functional following straight anastomosis however, due to the increased use of chemoradiotherapy in the pouch group, it is difficult to compare the groups and draw firm conclusions. Larger studies are necessary to provide clarity.