Management and results of complications after anterior resection with colonic pouch reconstruction for rectal cancer

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland
M KruschewskiH J Buhr

Abstract

Colonic J-pouch reconstruction is widely carried out during low anterior resection. The aim of this observational study was to describe the complications and evaluate the results of adverse event management. A total of 128 patients underwent an elective anterior resection with colorectal or coloanal J-pouch reconstruction for primary rectal cancer between January 1997 and December 2008. The overall mortality was 1.6%. Three (2.3%) patients developed pouch necrosis, one of whom died. The rate of anastomotic leakage was 11.7%. Other major complications included intra-abdominal abscess (3.1%), haemorrhage (0.8%) and abdominal dihiscence (0.8%). In all cases of anastomotic leakage, the pouch was salvaged, with 80% of patients undergoing surgical revision with relaparotomy and transanal suture. Patients with pouch necrosis underwent relaparotomy with removal of the pouch and a terminal colostomy. In all cases of intra-abdominal abscess without anastomotic leakage, radiologically controlled percutaneous drainage was carried out. Anal function can usually be saved after anastomotic leakage by salvage surgery without increase in mortality.

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Citations

Feb 16, 2011·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·Freddy Penninckx
Sep 8, 2012·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·H S SnijdersB A Bonsing

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