Application of sigmoid coloplasty after resection of middle or low rectal cancer / 中华消化外科杂志

ABSTRACT

Objective To investigate the feasibility of sigrnoid coloplasty for patients after resection of middle or low rectal carcinoma, and to evaluate the defecation function after the operation. Methods Forty-three patients with middle or low rectal cancer who had been admitted to the cancer Hospital of the Chinese Academy of Medical Sciences from January 2007 to January 2008 received sigrnoid coloplasty after rectal carcinoma resection (treatment group), and another 43 patients who had been admitted during the same period received colonic J pouch reconstruction (control group). The feasibility and safety of the 2 surgical procedures and postoperative defecation function were assessed. All data were processed by t test, chi-square test or Fisher exact probability. Results The sigmoid coloplasty was successfully performed in all patients in treatment group, while the reconstruction of the J pouch failed in 4 patients in the control group. Three patients in each group underwent temporary transverse colostomy. The incidences of postoperative complications in treatment group and control group were 7% (3/43) and 9% (4/43), respectively, with no statistical difference between the 2 groups (X2 =0. 282, P > 0.05). The median frequency of defecation in treatment group was 2.0 ± 1.5 per 24 hours, which was significantly less than 2.5 ± 1.0 in control group (X2 = 1. 242, P > 0.05). The fecal incontinence scores in treatment group and control group were 1.7 ± 0. 7 and 1.6 ± 0.8, respectively, with no statistical difference between the 2 groups (t = 0. 285, P > 0. 05). Conclusion Sigmoid coloplasty has similar benefits to colonic J pouch reconstruction, while sigmoid eoloplasty is relatively feasible, effective and safe for low colorectal or coloanal anastomosis.