Sphincter-saving operations are now generally accepted for the treatment of mid-rectal cancers. Different techniques have been described: low colorectal anastomosis with staplers, pull-through procedures and coloanal anastomosis. The functional results following these procedures are impaired by loss of the reservoir function of the rectum. To avoid frequency and urgency a J-shaped colonic reservoir is constructed and anastomosed to the anal canal. We are presenting our first four cases using this technique. All patients are personally reviewed 19-29 months after the operation. In correspondence with the literature all our patients had a good functional result with good continence and only one bowel movement per day. We conclude the creation of a neorectum makes the functional result of a coloanal anastomosis more predicable.