Videoproctographic assessment after restorative proctocolectomy.
Videoproctography was performed in 40 patients after restorative proctocolectomy to evaluate pouch emptying, anopouch angle, and pelvic floor movement in relationship to functional outcome. Results were compared between the two different pouch designs tested and a control group of 26 patients who had an intact rectum. There was no difference in emptying between the two pouch designs or compared with the control subjects. Emptying did not influence either the frequency of defecation or patient soiling rate. The presence of an anal stricture was associated with poor emptying in each case in the pouch group. Anorectal angle was no different between the different pouch designs or compared with the control group at rest, during pelvic floor contraction, or attempted defecation. A similar finding was obtained with anorectal angle position and movement during pelvic floor contraction and attempted defecation in both pouch design groups and when compared with normal rectum. This study shows that the only factor that is consistently associated with poor pouch emptying is the presence of an anal stricture.
Kmiot
W A
WA
Department of Surgery, Queen Elizabeth Hospital, Edgbaston, Birmingham, United Kingdom.
Yoshioka
K
K
Pinho
M
M
Keighley
M R
MR
D000328:Adult; D001003:Anal Canal / Q000033:anatomy & histology / Q000502:physiology; D003082:Colectomy / Q000379:methods*; D003672:Defecation; D005260:Female; D006801:Humans; D007082:Ileum / Q000000981:diagnostic imaging / Q000502:physiology / Q000601:surgery*; D008875:Middle Aged; D009132:Muscles / Q000502:physiology*; D010502:Perineum; D011859:Radiography; D012007:Rectum / Q000033:anatomy & histology / Q000502:physiology / Q000601:surgery*