Proctocolectomy with jejunal pouch-distal rectal anastomosis: An alternative to ileal pouch reconstruction |
| |
Authors: | Michinaga Takahashi MD James W Williams MD Keith A Kelly MD |
| |
Institution: | (1) Department of Surgery, Mayo Clinic Scottsdale, 13400 E. Shea Blvd., 85259 Scottsdale, AZ;(2) Laboratory Medicine/Pathology, Mayo Clinic Scottsdale, Scottsdale, Ariz.;(3) Samuel C. Johnson Medical Research Center, Mayo Clinic Scottsdale, Scottsdale, Ariz. |
| |
Abstract: | The aim of this study was to determine whether a jejunal pouch would have a lower resting pressure, be more distensible, and
have more interdigestive migrating myoelectric complexes and less fecal bacterial overgrowth than would an ileal pouch after
proctocolectomy and pouch-distal rectal anastomosis. In six conscious dogs with a jejunal pouch-distal rectal anastomosis
and six with an ileal pouch-distal rectal anastomosis (controls), pouch distensibility and motility were measured using a
barostat and perfused pressure-sensitive catheters passed per anum, pouch electrical activity was recorded using chronically
implanted electrodes, and the number of bacteria per gram of stool was assessed by culture. Dogs with a jejunal pouch had
lower resting pouch pressures, more distensible pouches, faster frequencies of pacesetter potentials in the pouch, more phase
3 intervals of the interdigesive migrating myoelectric complex reaching the pouch, but similar numbers and types of bacteria
in their stools compared to the dogs with an ileal pouch. We concluded that jejunal pouches have a lower resting pressure,
are more distensible, have more cleansing contractions, but a similar fecal flora compared to ileal pouches. A jejunal pouch
has features that make it an attractive alternative to an ileal pouch for pouch-distal rectal or pouch-anal canal anastomosis
after proctocolectomy.
Supported by the Mayo Foundation, Tohoku University, and the Nigro grant.
Presented at the Thirty-Eighth Annual Meeting of The Society for Surgery of the Alimentary Tract, Washington, D.C., May 11–14,
1997. An abstract of this work was published in Gastroenterology 112:A1478, 1997. |
| |
Keywords: | |
本文献已被 ScienceDirect SpringerLink 等数据库收录! |
|