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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
|November 1, 1989
PubMed
Summary
This summary is machine-generated.

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The rectal J-pouch reservoir significantly reduces fecal frequency and tenesmus after low anterior resection surgery for gynecologic cancer. This surgical technique improves 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 frequency and tenesmus in up to 70% of patients.

Purpose of the Study:

  • To evaluate the efficacy of a rectal J-pouch reservoir in mitigating post-coloproctostomy symptoms.
  • To assess the safety and functional outcomes of this reconstructive technique.

Main Methods:

  • A pilot study involving six patients with gynecologic malignancy undergoing low anterior resection with very low coloproctostomy (below 6 cm).
  • Construction of a rectal J-pouch reservoir utilizing a Strasbourg-Baker end-to-side coloproctostomy.

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Main Results:

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

Conclusions:

  • The rectal J-pouch reservoir is a viable surgical technique to prevent fecal frequency and tenesmus after very low coloproctostomy.
  • This method offers a favorable functional outcome for patients undergoing complex colorectal surgery for gynecologic cancers.