[Stomach and rectum replacement with pouches--is less more?].

Abstract

The effects of pouch reconstruction on long term are dependent not only on the capacity of the pouch, but also on its motility and contractibility. Problems with evacuation of the pouches in the upper and lower abdominal tract may become a major problem in a significant part of the patients. Thus the length of the pouches should be limited to 5 cm at the most in patients with complete rectal resection and to 10-15 cm after gastrectomy. The evacuation profile of the pouches is influenced in addition by the outlet characteristics of the pouch. Finally one should take into consideration that the beneficial effects of pouch reconstruction disappear with time due to adaptation of the bowel after straight reconstruction procedures, while on the other hand the evacuation problems persist.