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Ulrich, A.* ; Z'graggen, K.* ; Schmitz-Winnenthal, H.* ; Weitz, J.* ; Büchler, M.W.*

The transverse coloplasty pouch.

Langenbecks Arch. Surg. 390, 355-360 (2005)
DOI PMC
BACKGROUND: The introduction of the total mesorectal excision (TME) and the use of modern staplers have improved outcome and increased the rate of sphincter-preserving low anterior resections in rectal cancer. Consequently, the interest in functional results after rectal reservoir reconstruction increased significantly. METHODS: A review of the current literature was conducted on the development of colon pouch procedures with a particular focus on the transverse coloplasty pouch compared with the colon J-pouch and other current techniques of reconstruction after TME such as the side-to-end anastomosis. RESULTS: The colon J-pouch (CJP) became the "gold standard" for rectal reservoir reconstruction owing to better early functional results compared with the straight coloanal anastomosis (CAA). However, 30% of the patients with CJP faced late evacuation problems requiring the chronic use of enemas or laxatives. This rate could be decreased by shortening the limb of the CJP from 8-10 to 5-6 cm, but the late evacuation problems remained in approximately 10% of the patients. An overview of the current knowledge on technical and functional aspects as well as indications and results of the transverse coloplasty pouch (TCP) is presented. CONCLUSION: The TCP was developed to provide early functional results comparable to the CJP while avoiding the late evacuation problems. Functional results after TCP, small colon J-pouch and side-to-end anastomosis are similar. Evacuation problems after TCP have not been reported.
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Publication type Article: Journal article
Document type Review
ISSN (print) / ISBN 1435-2443
e-ISSN 1435-2451
Journal Langenbeck's Archives of Surgery
Quellenangaben Volume: 390, Issue: 4, Pages: 355-360 Article Number: , Supplement: ,
Publisher Springer
Publishing Place Berlin ; Heidelberg [u.a.]
Reviewing status Peer reviewed
Institute(s) Institute of Pancreatic Islet Research (IPI)