Clinical and Experimental Studies on the Hemodynamics of the Pelvic J Pouch in Ileoanal Anastomosis

Yoshihisa Fujimoto

The Second Department of Surgery, Hyogo College of Medicine

The purpose of this study was to investigate the efficacy of reserving the ileocolic artery in the pelvic J pouch. Mucosal blood flow of human terminal ileum was measured. It decreased significantly (p<0.05) with clamping the ileocolic artery and the vein and increased significantly (p<0.01) after declamping. Dogs were used in an experimental model of ileal ischemia. Mucosal blood flow was decreased significantly after arterial and venous ligation, and it recovered one week later. But the rate of decrease of mucosal blood flow obtained by applying intraluminal pressure (50 cm H₂O) was significantly higher in ischemic ileum than normal ileum. An experimental model of ischemic ileitis was carried out in dogs by ligation of the ileal artery and vein and/or closure of the terminal ileum. Mucosal blood flow was measured in each group, and histological examinations were performed in sacrificed dogs. The mucosal blood flow of the terminal ileum in the dogs was significantly lower in the arterial and venous ligation group (p<0.01) and also arterial and venous ligation associated with ileal obstruction group (p<0.05) than in the control group. These results seem to suggest that ischemia may be one of the causes of pouchitis. Careful treatment during surgery is necessary in the contruction of the pelvic pouch.

Key words
ileoanal anastomosis, ischemic pouchitis, hemodynamics of the pelvic J pouch

Reprint requests
Yoshihisa Fujimoto Second Department of Surgery, Hyogo College of Medicine
1-1 Mukogawa-cho, Nishinomiya, 663 JAPAN

Accepted
June 8, 1994

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