Background: The development of sphincter saving procedures for low carcinoma rectum has been the consequence of oncological and technological factors. The major disadvantage associated with these procedures is the development of Anterior resection syndrome because of the resection of rectal reservoir. Colonic J Pouch neorectum has been practiced as an antidote to overcome this problem. We are working at a tertiary care centre which is a high volume centre for rectal cancers. We thought it worthwhile to assess the efficacy of J Pouch neorectum viz-a-viz a straight coloanal anastamosis for low rectal cancers.
Methods: A prospective randomized study (June 2007-December 2009) of low rectal cancers(4-12centimeters from anal verge).One group(20 patients) subjected to low/ultralow anterior resection with straight anastamosis(SA) and other group(22 patients) to Colonic J Pouch(CJP).The two groups were compared on basis of Functional Outcome and, Composite Incontinence score .
Results: Anastomotic leak, strictures, frequency of bowel movements, nocturnal bowel movements, use of retarding medication, and incontinence to solids, liquids and gases were seen more in SA group. All these findings were statistically significant. Statistical methods used were Fischer’s exact test, Chi square test using SPSS 15.
Conclusion: We conclude that CJP has a significant functional advantage over SA and improves the overall quality of life in patients of low rectal cancers and the advantage persisted over a period of more than 6 months.
