Colonic pouch after low anterior resection of the distal third of the rectum.

Very low anterior resection with construction of colo-anal anastomosis for carcinoma of the distal third of the rectum may result in an increased bowel frequency and urgency. These latter problems have been correlated directly with the decreased capacity and compliance of the neo-rectum. Clinical trials have shown a significant advantage of the colonic pouch-anal anastomosis over conventional colo-anal anastomosis in decreasing post-operative bowel frequency and urgency as the former increases neo-rectal capacity. Recent innovations in pouch design and construction with the ingenious use of mechanical stapling devices will enable the widespread use of the colonic pouch to benefit more patients who require very low anterior resection for carcinoma of the distal third of the rectum.