Studies on Neorectoanal Function after Restorative Proctocolectomy with Ileal "W" Pouch-Anal Anastomosis for Ulcerative Colitis and Familial Polyposis Coli

Kensuke Yamai

First Department of Surgery, Niigata University School of Medicine (Director: Prof. Terukazu Muto)

Clinical defecatory function, neorectoanal manometry and pouchography were assessed in 21 patients (18 with ulcerative colitis and three with familial polyposis coli) treated by restorative proctocolectomy with ileal W pouchanal anastomosis. The results are as follows: 1) The clinical score of neorectal function improved with time. 2)Daily stool frequency decreased with time and was 4.3±1.2 at 6 months after ileostomy closure, 3.8±1.2 at 12 months, and 3.3±1.0 at 24 months. 3) There was an inverse linear relationship between daily stool frequency and maximal tolerated reservoir volume. 4) The horizontal diameter and dilatation ratio of the reservoir were significantly greater than those of the normal rectum. There were inverse linear relationships between daily stool frequency and horizontal diameter of the reservoir, and daily stool frequency and dilatation ratio of the reservoir. These results, show that maximal tolerated volume, horizontal diameter and dilatation ratio of the reservoir reflected neorectoanal function well, and we conclude that restorative proctocolectomy with ileal W puoch-anal anastomosis is a very effective operation for patients with ulcerative colitis and familial polyposis coli.

Key words
ileal W pouch-anal anastomosis, ulcerative colitis, familial polyposis coli, rectoanal manometric study, pouchography

Reprint requests
Kensuke Yamai First Department of Surgery, Niigata University School of Medicine
1-754 Asahimachidori, Niigata, 951 JAPAN

Accepted
February 14, 1990

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