Colo-anal pouches: lessons from a prospective audit

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland
S JeyarajahLeicester Colorectal Specialist Group

Abstract

Colonic pouch formation with pouch-anal anastomosis is the treatment of choice following restorative anterior resection for low rectal cancers with a proximal loop ileostomy to defunction the anastomosis. Controversy exists as to whether anastomotic integrity needs to be checked prior to ileostomy reversal. The aim of this prospective study was to audit our current practice. Data on all patients undergoing resectional surgery for rectal cancer in our unit are entered prospectively onto a database. Patients who underwent an anterior resection with pouch formation and defunctioning ileostomy were identified and a review of notes and radiological records was carried out. Forty-two patients with rectal adenocarcinoma underwent an anterior resection with colo-colonic pouch, colo-anal anastomosis and a covering loop ileostomy. Of these, 38(90.5%) had water-soluble contrast enemas (WSCE) 6-8 weeks postoperatively. Two studies (5.3%) confirmed the presence of normal colo-colonic pouch but 24(63.2%) normal reports made no mention of the presence of pouch. Three studies (7.9%) reported true leaks, one study (2.6%) an anastomotic stricture and eight studies (21.1%) anastomotic leaks. Review by radiologists and surgeons, and examination wi...Continue Reading

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Citations

Nov 8, 2008·Annals of the Royal College of Surgeons of England·Robin KennedyPaul J Finan
Jul 13, 2021·International Journal of Colorectal Disease·Simon LindnerFlorian Herrle

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