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    • Evaluation of Transverse Coloplasty Anastomosis (TC) after Low Anterior Resection in Mid and Low Rectal Cancer

    Ahmed Morad, MD; Yasser El Ghamrini, MD
    General Surgery Department , Faculty of Medicine – Ain Shams University, Cairo – Egypt

    Background: transverse coloplasty pouch is technically simple and represents an ideal procedure between straight coloanal anastomosis and colonic. J pouch anastomosis after total mesorectal exclusion for mid and low rectal cancer. Objective: to compare early complication and functional outcome in patients underwent straight coloanal anastomosis with those who underwent reconstruction using transverse coloplasty pouch for management of mid and low rectal cancer. Methods: 40 patients underwent low anterior resection with total mesorectal excision for mid and low rectal cancer, they are divided randomly into 2 equal groups each 20 patients, reconstruction done in group A with straight coloanal anastomosis (SA), in group B with transverse coloplasty pouch (TC). Early postoperative complications, mortality were recorded in both groups. Functional outcome of the neorectum is regards motion frequency, sensation of complete evacuation, need of regular antidiarhea medication and composits incontinence score are compared in both groups 10 days, 3 months and 6 months postoperatively. Results: no significant difference between both groups as regard early postoperative complications but patients in group with transverse coloplasty pouch shows better significant functional outcome as regard defecation frequency. 94% of patients in group of transverse coloplasty achieved perfect continent after 6 months postoperatively which was only in 15.8% in group with straight anastomosis (P value > 0.001). Conclusion: Transverse coloplasty pouch (TC) coloanal anastomosis after low anterior section with total mesorectum excision for mid and low rectal cancer is feasible, with better functional outcome than straight coloanal anastomosis. 

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