A Pathophsiological Study Using Manometry on Patients with Soiling after Ileal J Pouch-Anal Anastomosis

Ryouichi Tomita, Yasuhiko Kurosu, Masaru Isozumi, Katsuhisa Tanjoh, Keimei Munakata

First Department of Surgery, Nihon University School of Medicine

Twelve patients with ulcerative coliltis (UC) and adenomatosis coli (AC) were manometrically studied and compared with 15 healthy volunteers as controls. All of these 12 patients underwent total colectomy, mucosal proctectomy, and ileal J pouch-anal anastomosis (short rectal cuff). There was 8 men and 4 women, aged 14-56 years (mean 39.2 years). The median follow-up time from closure of the diverting ileostomy was 53.9 months (ragne 20-106) . No patient experienced any major complications in the postoperative course. Five patients did experience a small amount of occasional soiling, and compared with the remaining seven and 15 healthy volunteers, the group of five patients with soiling showed the lowest results in the anaorectal manometry (anal sphincer dysfunction; shorten of anal canal length, lower resting and squeeze pressure, anorectal sensory dysfunction; increase of sensory threshold volume, rest-rectal capacity dysfunction; decrease of complicance). These results are probably due to remaining inflammation at the rectal cuff in the UC group and injury to the anorectal apparatus caused during the operation.

Key words
ileo-anal anastomosis, manometric study, soiling

Reprint requests
Ryouichi Tomita First Department of Surgery, Nihon University School of Medicine
30-1 Ohyaguchi Kamimachi, Itabashi-ku, Tokyo 173 JAPAN

Accepted
September 14, 1994

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