Colonic pouch confers better bowel function and similar postoperative outcomes compared to straight anastomosis for low rectal cancer

Table 1 Comparison of the baseline characteristics of the study patients

Character	Colonic pouch	Straight anastomosis	P value
Number	35	37	-
Sex, male/female	18/17	15/22	0.35
Age in yr, median (range)	58.1 (30.0-79.0)	61.3 (41.0-76.0)	0.25
BMI	23.4	23.6	0.88
Temporary stoma, n (%)	28 (80)	24 (67)	0.89
Tumor height above anal verge in cm, median (range)	3.9 (2.0-6.0)	4.9 (3.0-6.0)	< 0.05
Anastomotic height above anal verge in cm, median (range)	1.9 (1.0-4.0)	2.5 (1.0-4.0)	< 0.05
J pouch/H pouch/side-to-end anastomosis	27/2/6	-	-
TNM stage, I/II/III/IV	17/9/9/0	12/14/11/0	0.35
Distal resection margin in cm, mean ± SD	1.5 ± 0.5	1.5 ± 0.6	0.93
No. collected lymph nodes, mean ± SD	15.1 ± 4.9	14.4 ± 2.6	0.52
Proximal resection margin in cm, mean ± SD	11.6 ± 2.7	11.4 ± 2.3	0.37
Postoperative chemotherapy	16	18	0.80

BMI: Body mass index; SD: Standard deviation; TNM: Tumor-node-metastasis.

Table 2 Comparisons of the perioperative surgical outcomes between the two study groups

Parameter	Colonic pouch	Straight anastomosis	P value
Operating time in min, mean ± SD	267.9 ± 58.6	247.8 ± 48.5	0.12
Blood loss in mL, mean ± SD	77.7 ± 69.2	95.7 ± 91.9	0.35
Flatus passage in d, mean ± SD	3.0 ± 1.3	2.9 ± 1.5	0.81
Excrement passage in d, mean ± SD	3.9 ± 1.3	3.7 ± 1.4	0.51
Hospitalization in d, mean ± SD	9.4 ± 5.3	10.3 ± 4.9	0.44
Postoperative complications, n (%)			0.55
Total	11 (31.4)	13 (35.1)
Anastomotic leakage	4 (11.4)	6 (16.2)
Lung infection	1 (2.9)	1 (2.7)
Urinary retention	2 (5.7)	1 (2.7)
Chyle fistula	1 (2.9)	0
Bowel obstruction	0	3 (8.1)
Wound infection	2 (5.7)	1 (2.7)
Death	1 (2.9)	1 (2.7)

SD: Standard deviation.

Table 3 Comparisons of the functional outcomes between groups

Parameter	Colonic pouch group, n = 35				Straight anastomosis, n = 37
	Preop	1 mo	6 mo	12 mo	Preop	1 mo	6 mo	12 mo	1P value	2P value	3P value
Continence, n									0.69	0.44	0.40
Normal	35	2	15	17	37	5	10	18
Incontinent to gas	0	8	5	0	0	7	6	2
Occasional minor leak	0	17	10	11	0	19	16	14
Frequent major soiling	0	4	1	0	0	3	2	0
Total incontinence	0	0	0	0	0	0	0	0
Absence of feces	0	0	0	0	0	0	0	0
Urgency, n
Stool frequency, mean ± SD	5.0 ± 2.5	10.6 ± 2.3	5.2 ± 2.8	3.4 ± 2.0	4.6 ± 2.8	11.0 ± 2.2	7.4 ± 2.9	4.3 ± 1.9	0.43	< 0.05	0.07
Perineal irritation	8	29	20	16	9	30	27	22	0.46	0.18	0.54
Incomplete defecation	15	30	24	15	16	32	30	23	0.61	0.24	0.26
Fragmentation	10	28	22	15	14	30	26	22	0.79	0.61	0.37
Antidiarrheal medication	9	29	23	19	10	29	25	21	0.28	0.95	0.90
Use of laxatives	0	0	0	0	0	0	0	0	-	-	-

¹P value was calculated on the comparison of function between the two groups 1 mo postoperatively.

²P value was calculated on the comparison of function between the two groups 6 mo postoperatively.

³P value was calculated on the comparison of function between the two groups 12 mo postoperatively.

SD: Standard deviation.

Table 4 Local recurrence and distant metastasis in the two groups

TNM stage	Number		Local recurrences		Metastasis
	CP group	SA group	CP group	SA group	CP group	SA group
T1N0	7	5	0	0	0	0
T2N0	10	7	1	0	0	0
T3N0	4	4	0	0	1	1
T4N0	5	10	1	0	1	1
T1N1/2	0	0	0	0	0	0
T2N1/2	0	1	0	0	0	1
T3N1/2	3	3	0	0	1	1
T4N1/2	6	7	0	1	0	1

CP: Colonic pouch; SA: Straight anastomosis; TNM: Tumor-node-metastasis.