Anal sphincter function after colectomy, mucosal proctectomy, and endorectal ileoanal pull-through.
Anal sphincter function in patients before and after colectomy, mucosal proctectomy, and endorectal ileoanal pull-through was assessed prospectively. In 21 patients with ulcerative colitis, Gardner's syndrome, or familial polyposis, anorectal manometry was performed before and eight weeks after ileoanal pull-through. The mean +/- SEM maximal anal sphincter resting pressure decreased from 86 +/- 5 to 68 +/- 4 mm Hg after operation. The net change in pressure with squeeze, however, was greater after ileoanal pull-through than before operation (100 +/- 9 v 92 +/- 7 mm Hg). In 19 of 21 patients after operation, balloon dilation of the ileal pouch resulted in relaxation of the internal anal sphincter and contraction of the external anal sphincter. Mean +/- SEM 24-hour stool frequency decreased from 7.6 +/- 0.6 at one month to 6.2 +/- 0.5 at three months. It was concluded that ileoanal pull-through preserves continence and an acceptable stool frequency by maintaining nearly normal anal sphincter function.
D000293:Adolescent; D000328:Adult; D001003:Anal Canal / Q000503:physiopathology* / Q000601:surgery; D002648:Child; D003082:Colectomy; D003093:Colitis, Ulcerative / Q000601:surgery; D003111:Colonic Polyps / Q000601:surgery; D005260:Female; D005736:Gardner Syndrome / Q000601:surgery; D006801:Humans; D007082:Ileum / Q000601:surgery*; D008297:Male; D008365:Manometry; D008722:Methods; D008875:Middle Aged; D011446:Prospective Studies; D012007:Rectum / Q000601:surgery*; D012018:Reflex / Q000502:physiology