Clin Colon Rectal Surg 2001; 14(1): 033-040
DOI: 10.1055/s-2001-13139
Copyright © 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Low Colorectal and Coloanal Anastomosis

Asim Farid, David A. Margolin
  • Division of Colorectal Surgery, Henry Ford Hospital, Detroit, MI.
Further Information

Publication History

Publication Date:
31 December 2001 (online)

ABSTRACT

A low colorectal or coloanal anastomosis, also known as a sphincter-sparing procedure, involves the resection of the rectum with anastomosis deep in the pelvis to a rectal cuff or to the anus itself. This is a departure from the traditional teaching of performing abdominoperineal resection for carcinoma involving the middle and lower third of the rectum. In this article we review the anatomic considerations, indications, and techniques of performing these complex pelvic procedures.

REFERENCES

  • 1 Hedlund H. Colorectal resection and anal anastomosis with an intraluminal stapler in Hirschsprung's disease.  Pediatric Surg Int . 1997;  12 142-144
  • 2 Hida J, Yasutomi M, Maruyama T, Nakajime A. Coloanal anastomosis using a circular stapling device following perineal rectosigmoidectomy for rectal prolapse.  Surg Today . 1999;  29 93-94
  • 3 Miles E. Cancer of the rectum.  The Lettsonian Lectures, London: Harrison and Sons; 1923
  • 4 Williams N, Seow-Choen F. Physiological and functional outcome following ultra low anterior resection with colon pouch-anal anastomosis.  Br J Surg . 1998;  85 1029-1035
  • 5 Williams N S, Dixon M F, Johnston D. Reappraisal of the 5 centimeter rule of distal excision for carcinomas of the rectum: a study of distal intramural spread and of patients survival.  Br J Surg . 1983;  70 150-154
  • 6 Pollett W G, Nicholls R J. The relationship between the extent of distal clearance and survival and local recurrence rates after curative anterior resection for carcinoma of the rectum.  Ann Surg . 1983;  198 159-163
  • 7 Lazorths S, Vioght J J, Roques J. Distal intramural spread of carcinoma of the rectum correlated with lymph node involvement.  Surg Gynecol Obstet . 1990;  170 45-48
  • 8 Heald R J. The `Holy Plane' of rectal surgery.  J R Soc Med . 1988;  81 503-508
  • 9 Parks A. Transanal technique in low rectal anastomosis.  Proc Soc Med . 1972;  65 975-976
  • 10 Read T E, Kodner I J. Proctectomy and coloanal anastomosis for rectal cancer.  Arch Surg . 1999;  134 670-677
  • 11 Nagamatsu Y, Shirouzou K, Isomoto H, Ogata Y. Surgical treatment of lower rectal cancer with sphincter preservation using hand sewn coloanal anastomosis.  Surg Today Jpn J Surg . 1998;  28 696-700
  • 12 Church J M, Saad R, Tetal S. Predicting the functional results of anastomoses to the anus: the paradox of preoperative anal resting pressure.  Dis Colon Rectum . 1993;  36 895-900
  • 13 Ruo L, Guillem J G. Surgical management of primary colorectal cancer.  Surg Oncol . 1998;  7 153-163
  • 14 Gordon P H, Nivtvongs S. Principles and Practice of Surgery for the Colon, Rectum and Anus, 2nd ed. St.  Louis, MO: Quality Medical Publishing 1999: 3-39
  • 15 Paty P B, Cohen A M. Technical considerations for coloanal anastomosis and J-pouch.  Semin Radiat Oncol . 1998;  8 48-53
  • 16 Lazorthes F, Fages P, Chiotasso P. Resection of the rectum with construction of a colonic reservoir and coloanal anastomosis for carcinoma of the rectum.  Br J Surg . 1986;  73 136-138
  • 17 Hida J, Yasutomi M, Fujimoto K. Functional outcome after low anterior resection with low anastomosis for rectal cancer using the colonic J-pouch; prospective randomized study for determination of optimum pouch size.  Dis Colon Rectum . 1996;  39 986-991
  • 18 Chandler P J, Orkin B A. Rectal carcinoma: operative treatment. In: Beck DE, Wexner SD, eds. Fundamentals of Anorectal Surgery London: WB Saunders 1998: 301-367
  • 19 Z'graggen K, Maurer C A, Buchler M W. Transverse coloplasty pouch: a novel neorectal repair.  Dig Surg . 1999;  16 363-366
  • 20 Fazio V W, Mantyh C R, Hull T L. Colonic ``coloplasty''.  Novel technique to enhance low colorectal or coloanal anastomosis. Dis Colon Rectum . 2000;  43 1448-1450
  • 21 Maurer C A, Z'graggen K, Zimmermen W. Experimental study of neorectal physiology after formation of a transverse coloplasty pouch.  Br J Surg . 1999;  86 1451-1458
  • 22 Ramos J R. Laparoscopic very low anterior resection and coloanal anastomosis using the pull through technique.  Dis Colon Rectum . 1995;  38 1217-1219
  • 23 Operative Colorectal Surgery. Block and Moossa, eds. Philadelphia: WB Saunders 1994 8: 264-265
  • 24 Lazorthes F, Chiotasso R, Gamagami R A. Late clinical outcome in a randomized prospective comparison of colonic J-pouch and straight coloanal anastomosis.  Br J Surg . 1997;  84 1449-1451
  • 25 Barrier A, Marte P, Gallot D, Dugue L. Long term functional results of colonic J-pouch versus straight coloanal anastomosis.  Br J Surg . 1999;  86 1176-1179
  • 26 Joo J S, Latulippe J F, Alabaz O, Weiss E G. Long term functional evaluation of straight coloanal anastomosis and colonic J-pouch: is the functional superiority of colonic J-pouch sustained?.  Dis Colon Rectum . 1998;  41 740-746
  • 27 Orkin B A. Resection for colorectal cancer. In: Hicks TC, Beck DE, Opelka FG, Timmicke AE, eds. Complications of Colon and Rectal Surgery Baltimore: Williams & Wilkins 1996: 295-311
  • 28 Ganagami R A, Liagre A, Chiotasso P. Coloanal anastomosis for distal third rectal cancer.  Dis Colon Rectum . 1999;  42 1272-1275
  • 29 Cavaliere F, Pemberton J H, Cosimelli M. Coloanal anastomosis for rectal cancer: long term results at the Mayo and Cleveland Clinics.  Dis Colon Rectum . 1995;  38 807-812
  • 30 Holm T, Cedermark B, Rutquist L F. Local recurrence of rectal adenocarcinoma after curative surgery with and without preoperative radiotherapy.  Br J Surg . 1994;  8 452-455
  • 31 Berger A, Tiret E, Cunningham C, Dehni N, Parc R. Rectal excision and colonic pouch anal anastomosis for rectal cancer. Oncologic results at five years.  Dis Colon Rectum . 1999;  42 1265-1271
  • 32 Guillem J G. Ultralow anterior resection and coloanal pouch reconstruction for carcinoma of the distal rectum.  World J Surg . 1997;  21 721-727
  • 33 Havenga K, Fenker W E, McDermott K. Male and female sexual and urinary function after total mesorectal excision with autonomic nerve preservation for carcinoma of the rectum.  J Am Coll Surg . 1996;  182 495-502
  • 34 Fiiberti A, Audisio R A, Eangeri L. Prevalence of sexual dysfunction in male caner patients treated with rectal excision and coloanal anastomosis.  Eur J Surg Oncol . 1994;  2 43-46
    >