Document Detail


Anal canal pressure after ileal pouch-anal anastomosis with strengthened internal anal sphincter.
MedLine Citation:
PMID:  15622579     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: The aim of sphincter-saving operative techniques and creation of intestinal reservoirs is to improve the quality of life for patients with restorative prococolectomy. METHODS: In this study, 48 consecutive patients (19 males and 29 females of ages between 19 and 55 years; mean age, 35.52 years) with ulcerative colitis and familial adenomatous polyposis underwent ileal pouch-anal anastomosis after proctocolectomy in 1986 to 2002. In 26 patients (54.17 percent of the cases), 10 males and 16 females, ileal pouch-anal anastomosis was performed after a modified surgical technique for strengthening the internal anal sphincter by creation of a smooth muscle cuff through plication of a mucosectomized segment of residual rectum. Basal resting anal canal pressure and pressure after voluntary contraction were recorded preoperatively, one month after surgery, and every six months for two years. RESULTS: One month after the operation manometric results showed significantly higher values of resting pressure in patient with a plicated rectal segment than values measured preoperatively (P < 0.001). This effect was absent after the standard ileal pouch-anal anastomosis. With the rectal plication technique, basal pressure increased from a preoperative value of 69 +/- 6 mmHg up to 80 +/- 6 mmHg at the end of the second postoperative year (P < 0.001). CONCLUSIONS: We concluded that ileal pouch-anal anastomosis with rectal plication perhaps improved sphincter function. The operative technique did not affect anal squeeze pressure. Patients quality of life was improved for those undergoing the modified ileal pouch-anal anastomosis.
Authors:
Georgi L Kobakov; Daniel V Kostov; Temelko D Temelkov
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  47     ISSN:  0012-3706     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2004 Nov 
Date Detail:
Created Date:  2004-12-28     Completed Date:  2005-02-01     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1868-73     Citation Subset:  IM    
Affiliation:
Clinic of General and Operative Surgery, St. Marina University Hospital of Varna, Varna, Bulgaria. glkobakov@yahoo.co.uk
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MeSH Terms
Descriptor/Qualifier:
Adenomatous Polyposis Coli / surgery*
Adult
Anal Canal / physiology*,  surgery*
Anastomosis, Surgical
Colitis, Ulcerative / surgery*
Colonic Pouches*
Female
Humans
Ileum / surgery*
Male
Middle Aged
Pressure
Proctocolectomy, Restorative*
Quality of Life
Rectum / surgery*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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