Restoration of Intestinal Continuity after low anterior Resection of the Rectum Neorectal Reconstruction with J-pouch, Coloplasty, Side-to-End or End-to-End Anastomosis

Background and purpose: Rectal resection may impair bowel function. Are colonic pouch formation techniques appropriate to optimize neorectal function? Patients and methods: The author presents his own results of clinical trials and the recommendations of meta-analyses regarding different colonic pouch designs. Results: In general three variations of colonic pouch formations (colonic J-pouch, coloplasty, side-to-end anastomosis) are available. In most studies the colonic J-pouch was investigated. Coloplasty and the side-to-end anastomosis show favorable results. According to current scientific evidence the colonic J-pouch should be the preferred technique for neorectal reconstruction. Conclusion: Colonic pouch operations are reliable techniques to optimize neorectal function. Currently scientific evidence favors the J-pouch design. © 2010 Urban & Vogel, Muenchen.