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Related Experiment Videos

Rectal J-pouch reservoir to decrease the frequency of tenesmus and defecation in low coloproctostomy.

C R Wheeless1, R E Hempling

  • 1Union Memorial Hospital, Baltimore, Maryland 21218.

Gynecologic Oncology
|September 1, 1989
PubMed
Summary
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A rectal J-pouch reservoir may significantly reduce fecal frequency and tenesmus after low anterior resection with very low coloproctostomy for gynecologic cancer. This surgical technique offers improved patient outcomes by creating a low-pressure rectal reservoir.

Area of Science:

  • Colorectal Surgery
  • Gynecologic Oncology
  • Surgical Reconstruction

Background:

  • Low anterior resection with very low coloproctostomy is sometimes necessary for gynecologic malignancy.
  • Very low end-to-end anastomosis can lead to significant fecal urgency and tenesmus in up to 70% of patients.
  • Rectal J-pouch construction is a potential method to alleviate these post-surgical symptoms.

Purpose of the Study:

  • To evaluate the efficacy of a rectal J-pouch reservoir in patients undergoing very low coloproctostomy.
  • To assess the impact of this technique on fecal frequency and tenesmus.
  • To determine the safety and feasibility of the J-pouch reconstruction in this patient population.

Main Methods:

  • A pilot study was conducted between March 1987 and April 1988.

Related Experiment Videos

  • Eleven patients with gynecologic malignancy requiring low anterior resection and very low coloproctostomy (<6 cm) underwent rectal J-pouch reservoir construction.
  • A Strasbourg-Baker end-to-side coloproctostomy was utilized.

    • Main Results:

    • No postoperative complications were observed in the study cohort.
    • All patients reported having no more than three bowel movements per day post-surgery.
    • No patients required antidiarrheal medication, and all denied experiencing tenesmus.

    Conclusions:

    • The rectal J-pouch reservoir is a safe and effective surgical technique.
    • This method successfully avoids tenesmus and reduces fecal frequency after very low coloproctostomy.
    • J-pouch reconstruction offers a significant improvement in quality of life for patients undergoing these procedures.