title: [Posterior proctomucosectomy and ileal pull-through reconstruction: a new restorative procedure after total proctocolectomy].
abstract: We reported a new method of restorative proctocolectomy using posterior approach and pull-through reconstruction. This method obviated transanal manipulation, a major factor causing damage to the internal sphincter, thus preventing fecal incontinence due to sphincter dysfunction. Also, temporary ileostomy was not necessary because the spout of an S-pouch was pulled down below the anal verge and its distal free end acted as a diverting stoma while the more proximal, healing zone (future anastomotic line) was kept from fecal contamination. This method was applied to a 32-year-old woman with familial polyposis coli and a 50-year-old woman with ulcerative colitis. Their bowel movements steadily decreased to three times and five times a day, respectively. There was no fecal leakage or perianal excoriation. The advantages as well as disadvantages of this method compared with the conventional techniques were discussed.
authors.affiliation: First Department of Surgery, Faculty of Medicine, Kyoto University, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Maetani
authors.forename: H
authors.initials: H
authors.lastname: Onodera
authors.forename: T B
authors.initials: TB
authors.lastname: Park
authors.forename: D
authors.initials: D
authors.lastname: Ikeuchi
authors.forename: H
authors.initials: H
authors.lastname: Furuyama
authors.forename: S
authors.initials: S
authors.lastname: Umeyama
authors.forename: K
authors.initials: K
authors.lastname: Yonezawa
authors.forename: N
authors.initials: N
authors.lastname: Murao
authors.forename: T
authors.initials: T
authors.lastname: Manabe
authors.forename: M
authors.initials: M
authors.lastname: Imamura
mesh_terms: D011125:Adenomatous Polyposis Coli / Q000503:physiopathology / Q000601:surgery*; D000328:Adult; D003093:Colitis, Ulcerative / Q000503:physiopathology / Q000601:surgery*; D003672:Defecation; D005260:Female; D006801:Humans; D008875:Middle Aged; D016737:Proctocolectomy, Restorative / Q000379:methods*