BACKGROUND: The colonic pouch is considered as an alternative to the standard straight low anastomosis after resection for rectal cancer. The aim of this prospective randomized trial was to compare short- and long-term functional results of colonic J-pouch (CJP) and transverse coloplasty (TCP) after low anterior resection for rectal cancer. METHODS:Between 2000 and 2005, patients with mid or low rectal cancer scheduled for an elective sphincter-preserving resection were eligible. The primary end point was to compare bowel functional results 6 months and 3 years after ileostomy closure. Fecal incontinence score and a questionnaire that included items for clinical evaluation of bowel function were used. RESULTS:One-hundred six patients were randomized; 54 patients were allocated to the CJP group and 52 in the TCP group. There were no differences between the 2 groups in terms of demographic and clinical data. Overall, postoperative complication rate was 19.8% without differences between the groups. Two patients (1.9%; one in each group) presented with anastomotic dehiscence. Long-term incomplete evacuation rates were 29.2% in the CPT group and 33.3% in the CJP group, without substantial differences. Overall, short- and long-term functional outcomes of both procedures were comparable. No differences were observed in terms of fecal incontinence or in all the items included in the questionnaire. CONCLUSION:TCP reconstruction after rectal cancer resection and coloanal anastomosis is functionally similar to CJP both in short- and long-term outcomes. The TCP technique does not seem to improve significantly the incomplete defecation symptom respect to CJP. REGISTRATION NUMBER: NCT01396928; http://register.clinicaltrial.gov.
RCT Entities:
BACKGROUND: The colonic pouch is considered as an alternative to the standard straight low anastomosis after resection for rectal cancer. The aim of this prospective randomized trial was to compare short- and long-term functional results of colonic J-pouch (CJP) and transverse coloplasty (TCP) after low anterior resection for rectal cancer. METHODS: Between 2000 and 2005, patients with mid or low rectal cancer scheduled for an elective sphincter-preserving resection were eligible. The primary end point was to compare bowel functional results 6 months and 3 years after ileostomy closure. Fecal incontinence score and a questionnaire that included items for clinical evaluation of bowel function were used. RESULTS: One-hundred six patients were randomized; 54 patients were allocated to the CJP group and 52 in the TCP group. There were no differences between the 2 groups in terms of demographic and clinical data. Overall, postoperative complication rate was 19.8% without differences between the groups. Two patients (1.9%; one in each group) presented with anastomotic dehiscence. Long-term incomplete evacuation rates were 29.2% in the CPT group and 33.3% in the CJP group, without substantial differences. Overall, short- and long-term functional outcomes of both procedures were comparable. No differences were observed in terms of fecal incontinence or in all the items included in the questionnaire. CONCLUSION:TCP reconstruction after rectal cancer resection and coloanal anastomosis is functionally similar to CJP both in short- and long-term outcomes. The TCP technique does not seem to improve significantly the incomplete defecation symptom respect to CJP. REGISTRATION NUMBER: NCT01396928; http://register.clinicaltrial.gov.
Authors: A Farag; A N Mashhour; M Y Elbarmelgi; M M Raslan; A M Abdelsalam; A A Mohsen Journal: Ann R Coll Surg Engl Date: 2017-07-06 Impact factor: 1.891