H-pouch: new isoperistaltic colonic pouch for coloanal anastomosis after rectal resection for cancer: a pilot study.

PURPOSE

To date, there is a consensus to consider colonic J-pouch-anal anastomosis as the standard form of reconstruction after proctectomy for cancer. However, one drawback of colonic J-pouch is evacuation difficulties, which are observed at some degree in almost one-half of patients. To improve functional outcome after coloanal anastomosis, we describe a new technique of isoperistaltic colonic H-pouch.

METHODS

The functional results after construction of this pouch were assessed prospectively in ten patients and compared with those obtained in a control group of matched patients with a colonic J-pouch.

RESULTS

At six months and one year, there were no differences between both pouches for bowel function, continence score, and evacuation difficulties.

CONCLUSIONS

This preliminary study showed that the creation of a new isoperistaltic colonic H-pouch did not improve the functional results after coloanal anastomosis compared with colonic J-pouch. Because colonic H-pouch is technically more complex to fashion, it should not be performed routinely and the J-pouch remains the benchmark for routine clinical practice.