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직장암의 초저위 전방절제술 후 J-결장낭 재건술의 초기 성적

Early Functional Results of Ultra-low Anterior Resection with a Colonic J-pouch Anal Anastomosis in Mid or Low Rectal Cancer

대한대장항문학회지 1996년 12권 1호 p.109 ~ 115
박재갑 ( Park Jae-Gahb ) - 서울대학교 의과대학 외과학교실

Abstract


To evaluate the early functional results of ultra-low anterior resection with a colonic J-pouch anal anastomosis in mid or low rectal cancer, we retrospectively compared the clinical and functional results in 13 patients having a colonic J-pouch anal anastomosis(JA) and 13 patients having a straight coloanal anastomosis(SA). There were no significant differences in age, sex, tumor size, level of tumor and distal resection margins between the two groups. The mean duration of follow-up was 8.2(1∼17) months in patients with JA and 6.2(1∼12) months in patients with SA. Protecting ileostomy was performed in 4 cases in patients with JA and 2 cases in patients with SA. Radiation therapy was performed in 6 cases in patients with JA and 7 cases in patients with SA. Postoperative complication and histologic grade of the carcinomas and
Dukes stage were similar in the two groups. Postoperative radiation therapy increased daily stool frequency in SA group. Even though statistically not significant, there was a tendency of lower stool frequency and lower incidence of incontinence in patients with JA than in Patients with SA. Therefore, in selected cases, colonic J-pouch anal anastomosis should be considered in ultra-low anterior resection.

키워드

Ileal Pouch-Anal Anastomosis;Low Anterior Resection
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