Evaluation of Bowel Function after Low Anterior Resection and Anastomosis by Colonic Pouches Compared to direct Coloanal Anastomosis for Cancer Rectum

Background: Worldwide, colorectal cancer ranks third in cancer-related fatalities for both sexes. CRC affects over 5.25 million people globally, making it second only in cancer incidence behind breast cancer (7.79 million cases). Aim and objectives: In order to evaluate the efficacy of colonic pouch anal anastomoses vs straight ones following low anterior resection in terms of bowel function, postoperative complications, and cancer outcomes. Patients and methods: Forty patients undergoing sphincter-saving surgeries with straight or colonic pouch anastomoses from April 2022 to April 2024 were included in this prospective analysis. The patients had low rectal malignancy. Surgical procedures were performed on all patients at hospitals affiliated with Al-Azhar University. There were two groups of patients: Twenty patients with rectal cancer who underwent colonic pouch anal anastomoses and low anterior resection made up Group A. Group B consists of twenty patients who had Rectal cancer treated with low anterior resection and direct coloanal anastomosis. Results: When comparing the groups, we found that tumor height above the anal verge (in cm) and anastomotic height above the anal verge (in cm) were significantly different. The groups that were compared did not differ significantly in terms of postoperative chemotherapy, types of colonic pouches, temporary stoma, total lymph node count, distal resection margin in centimeters, or the number of lymph nodes collected. Conclusion: While early postoperative functional outcomes were similar between colonic pouches and straight anastomoses, the colonic pouch approach demonstrated superior functional recovery in terms of urgency and LARS scores at later follow-ups. These results support the idea that colonic pouches may help rectal cancer patients whose stool function has been negatively affected by low anterior resection.