Resection and colo‐anal anastomosis with colonic reservoir for rectal carcinoma

Sphincter‐saving operations are now generally accepted for the treatment of mid‐rectal cancers. Many techniques have been described: low colorectal anastomosis, pull‐through procedures, and colo‐anal anastomosis. The functional results following these operations are impaired by loss of the reservoir function of the rectum. In order to improve these results, a modification of Parks' colo‐anal anastomosis is proposed. A J‐shaped colic reservoir is constructed and its end is anastomosed to the anal canal. We have operated upon 31 patients using this technique. Mortality was 3.3 per cent. Functional results were evaluated in 24 patients having a follow‐up of more than 3 months. All were continent; mean number of bowel movements was 1.1 per day. Defaecation was spontaneous in 75 per cent of cases; in the remaining 25 per cent, evacuation of the reservoir was elicited by a small enema each two days. This technique, creating a neo‐rectum, can achieve an important place among the sphincter‐saving operations.

[1]  N. Williams.  The rationale for preservation of the anal sphincter in patients with low rectal cancer , 1984, The British journal of surgery.

[2]  D. Johnston,et al.  Survival and recurrence after sphincter saving resection and abdominoperineal resection for carcinoma of the middle third of the rectum , 1984, The British journal of surgery.

[3]  R. J. Heald,et al.  A survey of postoperative function after rectal anastomosis with circular stapling devices , 1983, The British journal of surgery.

[4]  R. Nicholls,et al.  The Relationship Between the Extent of Distal Clearance and Survival and Local Recurrence Rates After Curative Anterior Resection for Carcinoma of the Rectum , 1983, Annals of surgery.

[5]  R. Nicholls,et al.  The anal dilator in the conservative management of acute anal fissures , 1983, The British journal of surgery.

[6]  Goligher Jc.  Current trends in the use of sphincter-saving excision in the treatment of carcinoma of the rectum. , 1982 .

[7]  A. Parks,et al.  Resection and sutured colo‐anal anastomosis for rectal carcinoma , 1982, The British journal of surgery.

[8]  S. Matsuo,et al.  Total colectomy, mucosal proctectomy, and ileoanal anastomosis , 1980, Diseases of the colon and rectum.

[9]  S. Amano,et al.  Anorectal pressure and rectal compliance after low anterior resection , 1980, The British journal of surgery.

[10]  P. Belliveau,et al.  The British , 2022 .

[11]  J. Ranson,et al.  Abdominosacral resection for carcinoma of the midrectum: ten years experience. , 1978, Annals of surgery.

[12]  A. Parks,et al.  Function of the anal sphincters following colo‐anal anastomosis , 1977, The British journal of surgery.

[13]  C. Dukes,et al.  Local recurrences after sphincter‐saving excisions for carcinoma of the rectum and rectosigmoid , 1951, The British journal of surgery.