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The transverse coloplasty pouch

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Abstract

Background

The introduction of the total mesorectal excision (TME) and the use of modern staplers have improved outcome and increased the rate of sphincter-preserving low anterior resections in rectal cancer. Consequently, the interest in functional results after rectal reservoir reconstruction increased significantly.

Methods

A review of the current literature was conducted on the development of colon pouch procedures with a particular focus on the transverse coloplasty pouch compared with the colon J-pouch and other current techniques of reconstruction after TME such as the side-to-end anastomosis.

Results

The colon J-pouch (CJP) became the “gold standard” for rectal reservoir reconstruction owing to better early functional results compared with the straight coloanal anastomosis (CAA). However, 30% of the patients with CJP faced late evacuation problems requiring the chronic use of enemas or laxatives. This rate could be decreased by shortening the limb of the CJP from 8–10 to 5–6 cm, but the late evacuation problems remained in ∼10% of the patients. An overview of the current knowledge on technical and functional aspects as well as indications and results of the transverse coloplasty pouch (TCP) is presented.

Conclusion

The TCP was developed to provide early functional results comparable to the CJP while avoiding the late evacuation problems. Functional results after TCP, small colon J-pouch and side-to-end anastomosis are similar. Evacuation problems after TCP have not been reported.

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Author information

Authors and Affiliations

  1. Department of General, Visceral and Transplant Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany

    A. Ulrich, H. Schmitz-Winnenthal, J. Weitz & M. W. Büchler

  2. Berner Viszeralchirurgie, Klinik Beau-Site Hirslanden, Schänzlihalde 11, 3000, Bern 25, Switzerland

    K. Z’graggen

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  1. A. Ulrich
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  2. K. Z’graggen
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  3. H. Schmitz-Winnenthal
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  4. J. Weitz
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  5. M. W. Büchler
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Correspondence to K. Z’graggen.

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Ulrich, A., Z’graggen, K., Schmitz-Winnenthal, H. et al. The transverse coloplasty pouch. Langenbecks Arch Surg 390, 355–360 (2005). https://doi.org/10.1007/s00423-005-0563-6

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  • DOI: https://doi.org/10.1007/s00423-005-0563-6

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