Low rectal anastomosis following pelvic exenteration

It is now considered the standard of care to reestablish bowel continence following radical resection of tumors in the pelvis that involve the rectal sigmoid. Initially, this was done with an end-to-end anastomosis and this still is preferred when the anastomosis is above the mid-rectum. When the anastomosis is in the lower rectum a colonic J-pouch is preferred to improve continence. The techniques of these procedures are demonstrated in this article.