Taeniectomy Versus Transverse Coloplasty as Neorectum After Low Rectal Resection.

PURPOSE: Restorative surgery for rectal cancer is usually criticized by its functional outcomes. The aim of this study is to assess the efficacy "taeniectomy" pouch in comparison with transverse coloplasty pouch.

STUDY DESIGN: This was a prospective controlled study. Most patients who were candidate for low rectal resection presented to colorectal unit at Cairo university hospitals during the period from February 2013 to August 2016 were divided into two groups. The total number of patients enrolled in the study was 180 patients. Ninety patients were subjected to low rectal resection with the transverse coloplasty pouch, and 90 patients were subjected to low rectal resection with the newly described taeniectomy pouch. Safety and feasibility of both techniques were assessed about leakage, operative time, difficulty in evacuation, incontinence, number of daily motions and postoperative urgency. Both groups were assessed clinically, by means of defecography and anorectal manometry.

RESULTS: There was no significant statistical difference between taeniectomy and transverse coloplasty regarding postoperative leakage (P value = 0.988), postoperative mortality (P value = 0.99) and functional outcomes including number of motions per day (P value was 0.403 at 3 months and 0.361 at 12 months), urgency (P value was 0.688), continence grade (P value was 0.320 and 0.683 in 3 and 12 months, respectively) and manometric findings. However, taeniectomy is statistically significant better in terms of operative time (P value = 0.001).

CONCLUSIONS: Taeniectomy is a newly described, technically easier technique for pouch formation after low rectal resection that can be used as a safe and effective alternative for the widely used transverse coloplasty.