Straight coloanal or colon-J-pouch anal reconstruction

The function after a very low anterior resection is not always optimal and it is difficult to predict whether or not the outcome will be acceptable regarding bowel function. In analogy to reservoir surgery for ulcerative colitis and polyposis coli, a colonic reservoir has been suggested. This review describes the literature and discusses some questions where we still need new answers and probably new trials. Based upon the available literature a reconstruction with a colonic-J-pouch is probably mandatory to achieve an acceptable quality of life, due to the superior results among patients having had a colonic-J-pouch.