1997 Fiscal Year Final Research Report Summary
Functional outcome after low anterior resection for rectal cancer using the colonic J-pouch
| Project/Area Number |
07671436
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Digestive surgery
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| Research Institution | Kinki University |
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Principal Investigator |
HIDA Jin-ichi Kinki University School of Medicine, First Department of Surgery, Staff, 医学部, 助手 (20238306)
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| Co-Investigator(Kenkyū-buntansha) |
YASUTOMI Masayuki Kinki University School of Medicine, First Department of Surgery, Professor, 医学部, 教授 (60028438)
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| Project Period (FY) |
1995 – 1997
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| Keywords | Rectal cancer / Low anterior resection / Colonic J-pouch reconstruction / Lymph node metastases / Evacuation difficulty / Optimum pouch size |
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| Research Abstract |
1.The functional outcome after low anterior resection (LAR) using the colonic J-pouch was compared with that after LAR using straight anastomosis. The functional outcome following LAR for rectal cancer is improved by the colonic J-pouch construction. 2.We tried to justify use of the sigmoid colon in the construction of a J-pouch by the analysis of regional lymph node metastases. Node metastases were examined by the clearing method. Metastatic rate of pericolic node was only 1.1 percent. Resection of sigmoid colon is not required, and therefore, a J-pouch can be constructed using the sigmoid colon. 3.Optimum size of this pouch has yet to be determined.We initiated a prospective, randomized trial using 5-cm (5J) and 10-cm (10J) pouches to determine this size. Clinical functions were evaluted using a functional scoring system. Reservoir function was evaluated by anorectal manometory and evacuation function by the balloon expulsion and saline evacuation tests. The functional score was similar for the two groups, although reservoir function in the 5-J group was significantly less than in the 10-J group. Evacuation function in the 5-J group was significantly superior to that in the 10-J group. The 5-cm J-pouch conferred adequate reservoir function without compromising evacuation.
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