Anal Sphincter Function After Colectomy, Mucosal Proctectomy, and Endorectal Ileoanal Pull-through

Becker, James M.

doi:10.1001/archsurg.1984.01390170026006

Cited by 52 publications

(12 citation statements)

References 10 publications

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“…In the present manometric follow-up study, the decrease o f mean maximal resting anal sphincter pressure at 2 weeks after the mucosal proctectomy was not restored to the preoperative level after surgery in accor dance with previous reports [3,4,[10][11][12][13].…”

Section: Discussionsupporting

confidence: 80%

“…The rectoanal inhibitory re flex was not observed right after the first stage operation, but the changes o f resting anal canal pressure by balloon inflation could be elicited gradually over a length of time. Many manometric data revealed an absence o f neorectoanal inhibitory reflex af ter ileoanal pullthrough procedure [3,4,12,16], while Becker [13] found the positive reflex present in most patients with long rec tal muscular cuff. The rectal muscular cuff in the present study may be considered as a long type for dogs.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Manometric and Histologic Assessment following Proctocolectomy and Straight Enteroanal Anastomosis in Canines

Mibu

Itoh²,

Nakahara³

et al. 1991

Eur Surg Res

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Serial manometric studies were performed in mongrel dogs before and after total colectomy, mucosal proctectomy and interposed jejunoanal anastomosis without pouch. Fecal continence and body weight gain were clinically satisfactory by 28 weeks after surgery. Even at 28 weeks after the mucosal proctectomy, the mean maximal resting anal sphincter pressure was significantly lower than the preoperative level (p < 0.001). Neorectal compliance also decreased. The rectoanal inhibitory reflexes were not observed 2 weeks after the mucosal proctectomy but atypical to typical patterns gradually appeared up to 28 weeks following the mucosal proctectomy. Histologic examination showed no injury of anal sphincter muscles. Mild inflammation was found in the neorectal mucosal layer in all animals. Meissner’s plexus in rectal muscular cuff was almost completely disrupted. These data suggested that there is certain limitation in restoration of anoneorectal function after mucosal proctectomy and enteroanal anastomosis, though with gentle and careful operations.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Manometric and Histologic Assessment following Proctocolectomy and Straight Enteroanal Anastomosis in Canines

Mibu

Itoh²,

Nakahara³

et al. 1991

Eur Surg Res

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“…In this study there was no significant change in maximal squeeze pressure following restorative proctocolectomy. Others, however, have reported an increase in squeeze pressure after ileo-anal anastomosis in some patients (Becker 1984;Lindquist 1990). This increase in squeeze pressure following operation is said to be due to hypertrophy of the external sphincter.…”

Section: Physiological Determinants Of Pouch Function Manometrymentioning

confidence: 96%

Crohn’s Disease and Ulcerative Colitis

Kumar¹,

Alexander-Williams²

1993

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Cover illustration: Ch. 12, Fig. 12. A long strictureplasty in Crohn's disease. The incised gut is bent over in a loop and the posterior wall is sutured with a continuous seromuscular stitch. Ch. 23, Fig. 16. The steps in pouch construction. The beginning of the suture line for the anterior layer of a pouch; a small hole is made in the proximal limb of the pouch; completed pouch-anal stapled anastomosis.

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“…Wie die Untersuchungen zahlreicher Forschungsgruppen [1,13] und auch unsere eigenen Mel3werte an 15 nachuntersuchten Patienten zeigen, l~il3t sich mit Hilfe der Manometrie nachweisen, dab sowohl der Sphincter internus wie der Sphincter externus funktionstfichtig bleiben. Der Ruhedruck im Sphincter ist zwar nach Pouchanlage erniedrigt, aber immer noch deutlich nachweisbar.…”

Section: Physiologische Meljdaten Nach Ileoanalem Pouchunclassified

“…Hult6n und Mitarbeiter [3] beschrieben ffir die Compliance des Pouches eine ~ihnliche Megkurve wie ftir das Rectum. Sic sind mitbedingt durch eine deutliche Gr613enzunahme des Pouchvolumens [1]. Diese Mel3gr6gen ver~indern sich zum Teil w~ihrend des ersten Jahres postoperativ dynamisch.…”

Section: Physiologische Meljdaten Nach Ileoanalem Pouchunclassified

67. Pathophysiologie und technische Voraussetzungen f�r die Kontinenzerhaltung

Stern

1987

Langenbecks Arch Chiv

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Restoration of gastrointestinal continuity following total colectomy in patients with ulcerative colitis or familial polyposis can be achieved by construction of an ileal pouch and ileoanal anastomosis. In the development of the surgical technique three problems have emerged: a) pull-through operation; b) construction of the reservoir; c) anatomy and physiology of the sphincter system. The function of the continence organ can be evaluated by means of manometric, electromyographic and volumetric tests. The success of this complex surgical procedure also depends on the characteristics of the individual patient.

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Anal Sphincter Function After Colectomy, Mucosal Proctectomy, and Endorectal Ileoanal Pull-through

Cited by 52 publications

References 10 publications

Manometric and Histologic Assessment following Proctocolectomy and Straight Enteroanal Anastomosis in Canines

Manometric and Histologic Assessment following Proctocolectomy and Straight Enteroanal Anastomosis in Canines

Crohn’s Disease and Ulcerative Colitis

67. Pathophysiologie und technische Voraussetzungen f�r die Kontinenzerhaltung

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