Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Mar 27, 2021; 13(3): 303-314
Published online Mar 27, 2021. doi: 10.4240/wjgs.v13.i3.303
Colonic pouch confers better bowel function and similar postoperative outcomes compared to straight anastomosis for low rectal cancer
Zhen-Zhou Chen, Yi-Dan Li, Wang Huang, Ning-Hui Chai, Zheng-Qiang Wei
Zhen-Zhou Chen, Wang Huang, Ning-Hui Chai, Zheng-Qiang Wei, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400000, China
Yi-Dan Li, Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400000, China
Author contributions: Chen ZZ and Li YD made substantial contributions to conception and design; Huang W and Chai NH contributed to the acquisition of data, analysis, and interpretation; Chen ZZ wrote the manuscript; Wei ZQ supervised the work and edited the manuscript.
Supported by Chongqing Key Diseases Research and Application Demonstration Program (Colorectal Cancer Prevention and Treatment Technology and Research Application Demonstration), No. 2019ZX003.
Institutional review board statement: This study was approved by Ethics Committee of The First Affiliated Hospital of Chongqing Medical University (Approval No. 2019-250).
Informed consent statement: Considering that the research was retrospective, the need for patients’ informed written consent was waived.
Conflict-of-interest statement: Neither author has a potential conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Zheng-Qiang Wei, MD, Director, Doctor, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400000, China.
Received: December 2, 2020
Peer-review started: December 2, 2020
First decision: December 24, 2020
Revised: January 2, 2021
Accepted: January 14, 2021
Article in press: January 14, 2021
Published online: March 27, 2021
Research background

Colonic pouch anastomosis improves the quality of life of patients with rectal cancer > 7 cm from the anal margin. But whether colonic pouch anastomosis can reduce the incidence of rectal resection syndrome in patients with low rectal cancer (within 6 cm of the anal ring) is unknown.

Research motivation

Identify the role of colonic pouch for low rectal cancer.

Research objectives

Compare postoperative and oncological outcomes and bowel function of straight and colonic pouch anal anastomoses after resection of low rectal cancer.

Research methods

We conducted a retrospective study of 72 patients with low rectal cancer who underwent sphincter-saving procedures with either straight or colonic pouch anastomoses. Then, we explored the technical safety, functional results, and oncological safety of colonic pouch anastomosis after low and ultralow rectal resection by comparing with straight anastomoses.

Research results

There were no significant differences in postoperative and oncological outcomes between the colonic pouch and straight anastomosis groups. However, patients with colonic pouch construction had lower postoperative low anterior resection syndrome scores than the straight anastomosis group, suggesting better bowel function.

Research conclusions

Colonic pouch anastomosis is a safe and effective alternative to straight anastomosis after low and ultralow rectal resection. Moreover, colonic pouch anastomosis may provide better postoperative functional outcomes.

Research perspectives

Future prospective randomized trials are required to validate the findings of this study.