Surgery continues to be essential in the management of colorectal tumors. For patients with mid and low rectal tumors, sphincter-preserving techniques have become increasingly common and acceptable oncologic results can be achieved. In general, straight coloanal anastomoses are associated with relatively poor postoperative bowel function due to the loss of the rectal reservoir. To overcome this limitation, colonic reservoirs, such as the colonic J-pouch or transverse coloplasty have been developed. Over the last several years, a significant number of trials have been published in the surgical literature comparing these techniques. This manuscript describes the basis of the functionality outcomes following restoration of intestinal continuity after protectomy for colorectal cancer.