Evaluation of Defication Following Restorative Proctocolectomy with Ileal J-pouch Anal Canal Anastomosis and Mucosal Proctectomy with Ileal J-pouch Anal Anastomosis for Ulcerative Colitis by Manometric Study

Katsuhiko Arai, Akira Sugita, Takeshi Yamanouchi, Tsuneo Fukushima*, Hiroshi Shimada

Second Department of Surgery, Yokohama City University School of Medicine
*Department of Surgery, Yokohama City Munincipal Hospital

We investigated bowel frequency, soiling (continence), and the ability to discriminate between flatus and feces in 12 patients who underwent mucosal proctectomy with ileo-anal anastomosis (IAA) and 6 patients who underwent restorative proctocolectomy with ileo-anal canal anastomosis (IACA). Clinically, IACA patients suffering from soiling were rare, compared with IAA patients. In manometric study, the resting anal pressure of patients with IACA was better than that of those with IAA. Therefore, we considered that soiling (or incontinence) was related to resting anal pressure, and we rcommend IACA for is patients with anorectal disorder, rectovaginal fistula, and anal fissure. Preoperative anorectal manometry important in selecting IAA or IACA for patients with ulcerative colitis.

Key words
ileal J-pouch anal (or anal canal) anastomosis, manometric study, ulcerative colitis

Reprint requests
Katsuhiko Arai Second Department of Surgery, Yokohama City University School of Medicine
3-9 Fukuura. Kanazawa-ku, Yokohama, 236 JAPAN

Accepted
April 5, 1995

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