Ghahramani Leila, Yazdani Saeed, Derakhshani Saeed, Rezaianzadeh Abbas, Jalli Reza, Geramizadeh Bita, Safarpour Ali Reza, Rahimikazerooni Salar, Hosseini Seyed Vahid
Colorectal Research Center, Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran;
Department of General Surgery, Chamran Hospital, Tehran, Iran;
Iran J Med Sci. 2014 Mar;39(2):117-22.
The gold standard of the management of rectal cancer in the middle and lower parts is low anterior resection with coloanal anastomosis. About 50% of the patients undergoing this procedure might experience some complications because of the low capacity of the neorectum. The aim of this study was to evaluate ileal J-pouch interposition as a neorectum between the anal canal and the remaining colon in comparison to coloanal anastomosis and transverse coloplasty.
Twelve dogs, weighing 23-27 kg, were divided into three groups. After laparotomy, the volume of the primary rectum was measured so that it could be compared with that of the neorectum at the end of the study. After rectal resection in Group A, the colon was directly anastomosed to the anus. In Group B, a 5-cm longitudinal incision was made 2 cm proximal to the anastomosis and was sutured transversely (coloplasty). In Group C, a 5-cm ileal J-pouch was interposed between the colon and anus. After 8 weeks, the neorectum was evaluated for volume, radiology, and pathology.
All the samples were alive until the end of the study. The healing of the anastomotic lines was acceptable (pathologically) in all. The mean volume expansion was 20.9% in Group A, 21.7% in Group B, and 118.2% in Group C, with the latter being significantly higher than that of the other groups (P=0.03). Colon J-pouch and coloplasty after proctectomy in some situations have not been performable. This study evaluated the performance of ileal J-pouch interposition.
This study showed that ileal J-pouch interposition might produce an acceptable reservoir function and that it seems feasible and safe in selected cases.
中低位直肠癌治疗的金标准是低位前切除术加结肠肛管吻合术。约50%接受该手术的患者可能因新直肠容量低而出现一些并发症。本研究的目的是评估回肠J形贮袋置入术作为肛管与剩余结肠之间的新直肠，并与结肠肛管吻合术和横结肠成形术进行比较。
12只体重23 - 27千克的犬被分为三组。剖腹术后，测量原直肠的容积，以便在研究结束时与新直肠的容积进行比较。A组在直肠切除术后，将结肠直接与肛门吻合。B组在吻合口近端2厘米处做一个5厘米的纵行切口，然后横向缝合（结肠成形术）。C组在结肠和肛门之间置入一个5厘米的回肠J形贮袋。8周后，对新直肠进行容积、放射学和病理学评估。
所有样本在研究结束时均存活。所有吻合口的愈合情况（病理上）均可接受。A组平均容积扩张为20.9%，B组为21.7%，C组为118.2%，C组显著高于其他两组（P = 0.03）。在某些情况下，直肠切除术后的结肠J形贮袋和结肠成形术无法施行。本研究评估了回肠J形贮袋置入术的效果。
本研究表明，回肠J形贮袋置入术可能产生可接受的贮尿功能，并且在选定病例中似乎可行且安全。
