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  1. NTU Scholars
  2. 醫學院
  3. 醫學系
Please use this identifier to cite or link to this item: https://scholars.lib.ntu.edu.tw/handle/123456789/192149
Title: Comparison of Functional and Surgical Outcomes of Laparoscopic-Assisted Colonic J-Pouch Versus Straight Reconstruction after Total Mesorectal Excision for Lower Rectal Cancer
Authors: LIANG, JIN-TUNG
李伯皇
Keywords: podocalyxin;Gp135;immunohistochemistry;sialomucin
Issue Date: 2007
Journal Volume: v.14
Journal Issue: n.7
Start page/Pages: 1972-1979
Source: ANNALS OF SURGICAL ONCOLOGY 
Abstract: 
Background: To compare the functional and surgical outcomes of colonic J- pouch and straight anastomosis in the context that both reconstruction procedures were performed laparoscopically. Methods: The present study was a randomized prospective clinical trial. Patients with lower rectal cancer requiring laparoscopic total mesorectal excision were equally randomized to either laparoscopic- assisted colonic J-pouch reconstruction or laparoscopic straight end-to-end anastomosis. The techniques of the laparoscopic-assisted colonic J-pouch reconstruction are shown in the attached video. The primary end point was the comparison of functional results in both reconstruction methods. The secondary end points included the safety ( surgical morbidity and mortality), surgical efficiency, and postoperative recovery. Results: A total of 48 patients were recruited within 2-year periods, in consideration of statistical power of 90% for comparison. There was no marked difference between patient groups undergoing colonic J- pouch surgery (n = 24) and straight anastomosis (n = 24) in various demographic and clinicopathogic parameters. The anorectal function of patients by colonic J-pouch were better than those by straight anastomosis in 3 months after operation, as evaluated by stool frequency (mean +/- standard deviation: 4.0 +/- 2.0 vs. 7.0 +/- 2.4 times/day, P < . 001); use of antidiarrheal agents (29.2% [n = 7] vs. 75. 0% [n = 18], P = .004); and perineal irritation (45.8% [n = 11] vs. 79.2% [n = 19], P = . 037). Because of the relatively better bowel function in immediate postoperative period, patients by colonic J-pouch reconstruction were less disabled after surgery and had quicker return to partial activity (P = . 039), full activity (P < .001), and work (P < .001). Both reconstruction methods were performed with similar amounts of blood loss, complication rates, and postoperative recovery. However, the operation time was significantly longer in the colonic J-pouch group (274.4 +/- 34.0 vs. 202. 0 +/- 28.0 minutes, P < .001). Conclusions: Because laparoscopic-assisted creation of a colonic J-pouch achieved better short-term functional results of the anorectum and did not increase surgical morbidity, as compared with laparoscopic straight anastomosis, this reconstruction procedure could be recommended to patients with lower rectal cancer requiring laparoscopic total mesorectal excision.
URI: http://ntur.lib.ntu.edu.tw//handle/246246/91816
Appears in Collections:醫學系

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臺大位居世界頂尖大學之列,為永久珍藏及向國際展現本校豐碩的研究成果及學術能量,圖書館整合機構典藏(NTUR)與學術庫(AH)不同功能平台,成為臺大學術典藏NTU scholars。期能整合研究能量、促進交流合作、保存學術產出、推廣研究成果。

To permanently archive and promote researcher profiles and scholarly works, Library integrates the services of “NTU Repository” with “Academic Hub” to form NTU Scholars.

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