To compensate for the loss of the reservoir function, in 1986 Lazorthes et al.  and Parc et al.  presented their results with a colonic J-pouch as a neo-rectal reservoir. Since then a number of studies have been performed to assess the functional outcome of the colonic J-pouch and to compare the results with those of straight anastomoses [4, 8]. It has been shown that patients with the colonic J-pouch present a better adaptation (Figs. 5-7) and significantly better function in terms of frequency of defecation, presence of stool fragmentation, urgency, diarrhoea and incontinence . It has been further demonstrated that the optimal dimensions for the colonic J-pouch are between 6 and 7 cm, with a maximum of approximately 8 cm. Smaller pouches are associated with a reduced reservoir function, whereas larger ones are associated with evacuation difficulties . The incidence of symptomatic anastomotic leakage seems reduced because the colonic J-pouch has a superior blood flow at the proximal bowel end as compared to the straight colo-anal anastomosis . Neither the functional superiority nor the improved safety of the colonic pouch following a colo-anal anastomosis appear to have been challenged so far, however it has been speculated that the advantage of
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