Influence of ileal pouch capacity and anal sphincteric function on the clinical outcome after ileal pouch-anal anastomosis |
| |
Authors: | Yoshio Takesue Takashi Yokoyama Takashi Kodama Yoshiaki Murakami Yuji Imamura Yuichiro Matsuura |
| |
Institution: | (1) First Department of Surgery, Hiroshima University School of Medicine, 1-2-3 Kasumi, Minami-ku, 734 Hiroshima, Japan;(2) Department of General Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, 734 Hiroshima, Japan |
| |
Abstract: | This study was designed to determine the influence of ileal pouch capacity and anal sphincteric function on the clinical outcome
after ileal pouch-anal anastomosis. A total of 24 patients who had undergone ileal pouch-anal anastomosis (J pouch) for ulcerative
colitis were studied. The 24-hour stool frequency was found to be inversely correlated with the sensitivity threshold volume
(STV), maximal tolerance volume (MTV), and distensibility, but was independent of the maximal resting pressure and maximal
squeeze pressure. Patients experiencing nocturnal fecal incontinence had maximal resting pressures that were significantly
lower than those of nocturnally continent patients. Among the patients with fecal incontinence, those with frequent soiling
had lower resting pressures, STV, and distensibility than the patients with intermittent spotting. In addition, the STV in
patients needing nocturnal evacuation were lower than those of patients who did not evacuate after falling asleep. The conclusions
are as follows. Both stool frequency and the need for nocturnal pouch evacuation correlated directly with pouch volume. Anal
incontinence was more common in patients with low internal sphincteric function. In addition, frequent and gross nocturnal
incontinent patients demonstrate a worse function in both the anal sphincter and reservoir than those with intermittent spotting. |
| |
Keywords: | ileal pouch-anal anastomosis manometry anal sphincteric pressure pouch capacity incontinence |
本文献已被 SpringerLink 等数据库收录! |
|