What happens to the rectal muscular cuff? An experimental study in dogs.
The anatomy and histology of the rectal muscular cuff was studied in 15 dogs with an ileal pouch-anal anastomosis. Eight channel, three-dimensional anal manometry showed normal maximal squeeze pressure (128 +/- 20 mm Hg) compared to a control group (135 +/- 4 mm Hg). The rectal muscular cuff showed complete absence of the cuff in three cases. In 12 dogs, the rectal cuff was retracted to a length of less than 1 cm, the muscle fibers were degenerated and fibrotic. The results in the canine model and the clinical results of patients with an ileal pouch-anal anastomosis with a cuff demonstrated that a rectal muscular cuff is not essential to maintain continence after ileal pouch-anal anastomosis.
Department of Surgery, University of Amsterdam, The Netherlands.
J F
JF
Slors
R
R
Pietroletti
W A
WA
Bemelman
M E
ME
Schipper
P J
PJ
Klopper
W H
WH
Brummelkamp
D000818:Animals; D004285:Dogs; D005500:Follow-Up Studies; D008365:Manometry; D009130:Muscle, Smooth / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D016737:Proctocolectomy, Restorative; D012007:Rectum / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*