PROCTOCOLECTOMY AND STAPLED ILEOANAL ANASTOMOSIS WITHOUT MUCOSAL PROCTECTOMY

被引:14
作者
LANDI, E
FIANCHINI, A
LANDA, L
MARMORALE, C
CORRADINI, G
DELUCA, S
PILONI, V
机构
[1] Department of Surgery, Ancona University Hospital, Ancona
[2] Radiology Service, Geriatric Research Institute, Ancona
关键词
D O I
10.1007/BF00300406
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
The present study compared the outcome of a small series of patients (7 cases) who underwent total proctocolectomy without mucosal proctectomy and stapled ileal pouch-anal anastomosis made at the apex of the anal transitional zone, with our previous experience (17 cases) in which the ileal pouch was anastomosed at the dentate line after mucosectomy. Though not statistically significant, our limited experience showed excellent clinical results with better continence and discriminating ability of flatus from faeces in the former group. The resting anal pressure profile was not changed postoperatively. The operation time was significantly reduced compared with our previous approach which was a time-consuming procedure. There was an indication that risk of complications (pelvic sepsis and haemorrhage) was less. © 1990 Springer-Verlag.
引用
收藏
页码:151 / 154
页数:4
相关论文
共 12 条
  • [1] Nicholls R.J., Pezim M.E., Restorative proctocolectomy with ileal reservior for ulcerative colitis and familial adenomatous polyposis: a comparison of three reservoir designs, Br J Surg, 72, pp. 470-474, (1985)
  • [2] Nasmyth D.G., Johnson D., Godwin P.G.R., Dixon M.F., Smith A., Willia N.S., Factors influencing bowel function after ileal pouch-anal anastomosis, Br J Surg, 73, pp. 469-573, (1986)
  • [3] Keighley B., Abdominal mucosectomy reduces the incidence of soiling and sphincter damage after restorative proctocolectomy and J pouch, Dis Colon Rectum, 30, pp. 386-390, (1987)
  • [4] Scott N.A., Permberton J.H., Barkel D.C., Wolf B.G., Anal and ileal pouch manometric measurements before ileostomy closure are related to functional outcome after ileal pouch-anal anastomosis, Br J Surg, 76, pp. 613-616, (1989)
  • [5] Johnston D., Holdsworth P.J., Nasmyth D.G., Neal D.E., Priose J.N., Womack N., Axon A.T.R., Preservation of the entire anal canal in conservative proctocolectomy for ulcerative colitis: a pilot study comparing end-to-end ileo-anal anastomosis without mucosal resection with mucosal protectomy and endo-anal anastomosis, Br J Surg, 74, pp. 940-944, (1987)
  • [6] Piloni V., Ascoli G., Marmorale C., Pesaresi A., Antico E., Fianchini A., Risultati del “programma J-Pouch” per colite ulcerosa e poliposi familiare, Riv It Coloproct, 6, pp. 123-132, (1987)
  • [7] Duthie H.L., Gairns F.W., Sensory nerve endings and sensation in the anal region of man, Br J Surg, 47, pp. 585-595, (1960)
  • [8] Martin L.W., Torres A.M., Fischer J.E., Alexander F., The critical level for preservation of continence in the ileo-anal anastomosis, J Pediatr Surg, 20, pp. 664-667, (1985)
  • [9] Hulten L., Oresland T., Alternatives to the permanent ileostomy: the ileo anal pouch. Advances in Coloproctology, pp. 599-605, (1987)
  • [10] Dozois R.R., Goldberg S.M., Rothenberg D.A., Utsunomiya J., Nicholls R.J., Cohen Z., Hulten L.A., Restorative proctocolectomy with ileal reservoir, Int J Colorectal Dis, 1, pp. 2-19, (1986)