Chen ZZ, Li YD, Huang W, Chai NH, Wei ZQ. Colonic pouch confers better bowel function and similar postoperative outcomes compared to straight anastomosis for low rectal cancer. World J Gastrointest Surg 2021; 13(3): 303-314 [PMID: 33796217 DOI: 10.4240/wjgs.v13.i3.303]
Corresponding Author of This Article
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. 384535713@qq.com
Research Domain of This Article
Surgery
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
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 byChongqing 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: http://creativecommons.org/Licenses/by-nc/4.0/
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. 384535713@qq.com
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 Processing time: 105 Days and 21.9 Hours
ARTICLE HIGHLIGHTS
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.
