Straight Ileoanal Anastomosis v Ileal Pouch-Anal Anastomosis After Colectomy and Mucosal Proctectomy

Prospective controlled trial of duplicated (J) versus quadruplicated (W) pelvic ileal reservoirs in restorative proctocolectomy for ulcerative colitis.

“…The beneficial effect of a pelvic reservoir on stool frequency may therefore reside as much in its ability to modify or 'damp' ileal motility as in the increased capacity that it provides. Interruption of normal ileal peristalsis as ileum enters the reservoir may delay the onset of propulsive wave activity within the reservoir.16 [24][25][26][27] Capacious reservoirs also tend to be more compliant than less capacious ones,14 18 22 another finding that is supported by the results of this study, as we found that there was a significant correlation (r=0.365, p=0012) between maximum tolerated volume and compliance.…”

lleo-Anal Pouch Function and Dysfunction

“…a higher incidence of nocturnal incontinence (20 vs. 0%) and a higher rate of failure (32.0 vs. 1.3%) compared to patients with a J pouch. Generally, patients with J pouches were more satisfied with their func tional outcome and quality of life than pa tients with single-lumen ileum [6].…”

Restorative Proctocolectomy with Ileal Reservoir and Ileoanal Anastomosis for Ulcerative Colitis and Familial Polyposis

“…This adequately preserves anal continence and considerably shortens the operative time and minim izes blood loss. Though there is ample evidence that an ileal reservoir decreases stool frequency to an acceptable number and thus, is an essential component to this pro cedure, the ideal size and configuration of the reservoir is unclear [11,12], We have decreased the size of the 'S' reservoir from 15-cm limbs to three 12-cm limbs and have shortened the efferent limb from 5 to 3 cm. To date, we have not seen any functional difference in patients with the smaller 'S' pouches as compared to those in the initial series.…”