[Colo-anal anastomosis with reservoir in the treatment of rectal cancer]

Abstract

Preservation of the anal sphincter system is now often considered in the treatment of adenocarcinomas of the mid-rectum (inferior limit between 11 and 6 cm of the anal margin). Direct anastomosis of the rectum to the anus or the last two centimeters of the rectum after resection of the rectal pouch is a source of discomfort. The construction of a colon pouch, placed directly above the anus, has been devised in order to improve these results. In the last three years, a J-shaped colon pouch, measuring 8 centimeters X 2, was constructed in 76 patients and anastomosed in its portion to the anal canal, after complete rectal resection. The functional results of this procedure, with uneventful post-operative course, were evaluated in 66 patients with a mean follow-up of 17 months. Continence was satisfactory in 96% of patients, with an average number of stools of 1.4 in 24 hours. Thirty one per cent of the patients require a small enema or a suppository to induce defecation.