Is It a Safe Procedure

Colonic J-pouch anastomosis is a safe procedure and the incidence of clinical anastomotic leaks is lower than in straight anastomosis (0-15% vs. 5-27%) for a number of reasons:

• blood supply at the site of anastomosis is improved by using colonic J-pouch, as doppler flowmetry studies show;

• the volume of reservoir reduces the pelvic dead space, preventing pelvic collections and minimising pelvic sepsis [37, 38, 42, 49, 61].

It is not clear whether this reduced leak rate after J-pouch formation is influenced by the increased use of temporary faecal diversion or if anastomotic healing is really improved through benefits of colonic J-pouch reconstruction [26,62].

Referring to the incidence of anastomotic stricture, no study could find any difference between colonic J-pouch and straight anastomosis groups [48].

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