Application and evaluation of pouch configuration in rectal surgery.
- Author:
Chuangang FU
1
;
Xianhua GAO
Author Information
1. Department of Colorectal Surgery, Changhai Hospital, The Second Military Medical University, Shanghai 200433, China. fugang416@126.com.
- Publication Type:Journal Article
- MeSH:
Anal Canal;
surgery;
Anastomosis, Surgical;
methods;
Humans;
Ileum;
surgery;
Rectum;
surgery
- From:
Chinese Journal of Gastrointestinal Surgery
2014;17(5):431-434
- CountryChina
- Language:Chinese
-
Abstract:
Colonic pouch can improve fecal continence after low anterior resection in the short-term, but its superiority would disappear in the long-term (2 years after surgery), since fecal continence improves gradually with time in the non-pouch group. Furthermore, the incidence of incomplete defecation increases gradually with time, and a lot of patients would have difficulty in defecation and require long-term use of suppositories and enemas. Pouch enforcement will result in prolonged operation time and increased treatment cost. Therefore, the value of colonic pouch in low rectal anastomosis is being questioned, and its application diminishes gradually. For patients with ulcerative colitis (UC) or familial adenomatous polyposis (FAP) after total colectomy, ileal pouch anal anastomosis (IPAA) can reduce fecal frequency and improve patients' quality of life in both short-term and long-term, by increasing the volume of the neo-rectum and altering intestinal motility. For these reasons, IPAA is the first surgical choice for UC and FAP.
