Abstract
Twenty patients underwent proctocolectomy followed by an ileal pouch-anal anastomosis. The rectum was mobilized in the intersphincteric plane and transected at the level of the dentate line. As a consequence, a rectal cuff, which is considered by some to be important for the maintenance of anal continence, was not left behind. All patients were continent. Manometric data demonstrated no difference compared to a group of 21 patients with a conventional mucosectomy. Nearly half of the patients in both groups had a positive recto-anal inhibitory reflex. As a rectal cuff is not essential for maintaining continence, the receptors of the rectoanal inhibitory reflex are probably located outside the rectal wall.
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References
Taylor BA, Dozois RR (1987) The J ileal pouch-anal anastomosis. World J Surg 11:727–734
Schoetz DJ, Coller JA, Veidenheimer MC (1986) Ileoanal reservoir for ulcerative colitis and familial polyposis. Arch Surg 121:404–409
Fonkalsrud EW (1987) Update on clinical experience with different surgical techniques of the endorectal pullthrough operation for colitis and polyposis. Surg Gynecol Obstet 165:309–316
Nicholls RJ (1987) Restorative proctocolectomy with various types of reservoir. World J Surg 11:751–762
Williams NS, Johnston D (1985) The current status of mucosal proctectomy and ileo-anal anastomosis in the surgical treatment of ulcerative colitis and adenomatous polyposis. Br J Surg 72:159–168
Hepell J, Weiland LH, Perrault J, Pemberton JH, Telander RL, Beart RW (1983) Fate of the rectal mucosa after rectal mucosectomy and ileoanal anastomosis. Dis Colon Rectum 26:768–771
Heimann TM, Bolnick K, Aufses AH (1986) Results of surgical treatment in familial polyposis coli. Am J Surg 152:276–278
Wolfstein IH, Bat L, Neumann G (1982) Regeneration of rectal mucosa and recurrent polyposis coli after total colectomy and ileoanal anastomosis. Arch Surg 117:1241–1242
Heald RJ, Allen DR (1986) Stapled ileo-anal anastomosis: a technique to avoid mucosal proctectomy in the ileal pouch operation. Br J Surg 73:571–572
Brummelkamp WH, Slors JFM (1986) Ileal pouches. Br J Surg 73:940
Utsunomiya J, Iwama T, Imajo M, Matsuo S, Sawai S, Yaegashi K, Hirayama R (1980) Total colectomy, mucosal proctectomy and ileoanal anastomosis. Dis Col Rectum 23:459–466
Martin LW, LeCoultre C, Schubert WK (1977) Total colectomy and mucosal proctectomy with preservation of continence in ulcerative colitis. Ann Surg 186:477–480
Parks AG, Nicholls RJ, Belliveau P (1980) Proctocolectomy with ileal reservoir and anal anastomosis. Br J Surg 67:533–538
Peck DA (1980) Rectal mucosal replacement. Ann Surg 3:294–303
Grant D, Cohen Z, McHugh S, McLeod R, Stern H (1986) Clinical results and manometric findings with long and short rectal cuffs. Dis Col Rectum 29:27–32
Pescatori M, Mattana C, Castagneto M (1988) Clinical and functional results after restorative proctocolectomy. Br J Surg 75:321–324
Heppell J, Kelly KA, Philips SF, Beart RW Jr, Telander RL, Perrault J (1982) Physiologic aspects of continence after colectomy, mucosal proctectomy and ileo-anal anastomosis. Ann Surg 195:435–443
Pescatori M, Parks AG (1984) The sphincteric and sensory components of preserved continence after ileoanal reservoir. Surg Gynecol Obstet 158:517–521
Becker JM (1984) Anal sphincter function after colectomy, mucosal proctectomy, and endorectal ileoanal pullthrough. Arch Surg 119:526–531
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Slors, J.F.M., Taat, C.W. & Brummelkamp, W.H. Ileal pouch-anal anastomosis without rectal muscular cuff. Int J Colorect Dis 4, 178–181 (1989). https://doi.org/10.1007/BF01649699
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DOI: https://doi.org/10.1007/BF01649699