A novel colon pouch and its comparison with a straight coloanal and colon J-pouch anal anastomosis:: Preliminary results in pigs

被引:51
作者
Z'graggen, K
Maurer, CA
Mettler, D
Stoupis, C
Wildi, S
Büchler, MW
机构
[1] Univ Bern, Dept Visceral & Transplantat Surg, Inselspital, CH-3010 Bern, Switzerland
[2] Univ Bern, Dept Expt Surg, Inselspital, CH-3010 Bern, Switzerland
[3] Univ Bern, Dept Radiol, Inselspital, CH-3010 Bern, Switzerland
关键词
D O I
10.1016/S0039-6060(99)70297-7
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background. Early functional results after complete rectal resection and straight coloanal anastomosis are often characterized by frequent bowel movements, urgency, and: varying degrees of stool incontinence. The formation of a colon reservoir improves early and long-term-function, We evaluated the feasibility of a novel, modified design of a colon pouch-anal anastomosis in pigs and compared the results with those of pigs with straight coloanal anastomosis and colon J-pouch. Methods. Complete rectal resection followed by either a straight coloanal anastomosis, a colon J-pouch, or a novel design of a colon pouch was performed in Equal numbers in 15 pigs. By transversely closing a longitudinal colotomy, the new, technically simpler pouch is formed. Functional results were assessed during a period of 6 weeks. Results. All IT procedures were successful. The novel colon pouch required less surgical time than the colon J-pouch, and the formation of the pouches did not reduce tissue perfusion as assessed by laser Doppler flowmetry. The mean volume of the novel colon pouch was significantly smaller than the volume of the colon J-pouch. All the pigs with the novel colon pouch had normal stool frequency and consistency during a period of 6 weeks. In the group with straight coloanal anastomosis, two pigs had increased frequency of defecation, one pig showed signs of urgency and perianal dermatitis, and three had substantially reduced stool consistency. Of the four pigs with colon J-pouch, three had signs of impaired pouch evacuation and two had reduced stool frequency. Conclusions. The novel colon pouch is feasible in pigs and technically simpler than the colon J-pouch. These preliminary results indicate that the smaller capacity of this pouch seems sufficient for normal defecation. Its short-term functional results were better than those after reconstruction with a colon J-pouch or a straight coloanal anastomosis.
引用
收藏
页码:105 / 112
页数:8
相关论文
共 25 条
[1]   THE TECHNIQUE OF INTESTINAL STRICTUREPLASTY [J].
ALEXANDERWILLIAMS, J .
INTERNATIONAL JOURNAL OF COLORECTAL DISEASE, 1986, 1 (01) :54-57
[2]  
DRAKE DB, 1987, ANN SURG, V206, P600
[3]   EN-BLOC PELVIC LYMPHADENECTOMY AND SPHINCTER PRESERVATION IN THE SURGICAL-MANAGEMENT OF RECTAL-CANCER [J].
ENKER, WE ;
HEILWEIL, ML ;
HERTZ, REL ;
PILIPSHEN, SJ ;
STEARNS, MW ;
STERNBERG, SS ;
JANOV, AJ .
ANNALS OF SURGERY, 1986, 203 (04) :426-433
[4]   Laser Doppler blood flow measurement in rectal resection for carcinoma - Comparison between the straight and colonic J pouch reconstruction [J].
Hallbook, O ;
Johansson, K ;
Sjodahl, R .
BRITISH JOURNAL OF SURGERY, 1996, 83 (03) :389-392
[5]   Randomized comparison of straight and colonic J pouch anastomosis after low anterior resection [J].
Hallbook, O ;
Pahlman, L ;
Krog, M ;
Wexner, SD ;
Sjodahl, R .
ANNALS OF SURGERY, 1996, 224 (01) :58-65
[6]  
HEALD RJ, 1986, LANCET, V1, P1479
[7]   THE MESORECTUM IN RECTAL-CANCER SURGERY - THE CLUE TO PELVIC RECURRENCE [J].
HEALD, RJ ;
HUSBAND, EM ;
RYALL, RDH .
BRITISH JOURNAL OF SURGERY, 1982, 69 (10) :613-616
[8]   INTRAOPERATIVE PREDICTION OF ISCHEMIC-INJURY OF THE BOWEL - A COMPARISON OF LASER DOPPLER FLOWMETRY AND TISSUE OXIMETRY TO HISTOLOGICAL ANALYSIS [J].
KROHGSORENSEN, K ;
LINE, PD ;
HAALAND, T ;
HORN, RS ;
KVERNEBO, K .
EUROPEAN JOURNAL OF VASCULAR SURGERY, 1992, 6 (05) :518-524
[9]   FUNCTION AFTER ANOABDOMINAL RECTAL RESECTION AND COLONIC-J POUCH ANAL ANASTOMOSIS [J].
KUSUNOKI, M ;
SHOJI, Y ;
YANAGI, H ;
HATADA, T ;
FUJITA, S ;
SAKANOUE, Y ;
YAMAMURA, T ;
UTSUNOMIYA, J .
BRITISH JOURNAL OF SURGERY, 1991, 78 (12) :1434-1438
[10]  
Kusunoki M, 1997, BRIT J SURG, V84, P1277