[A clinical and instrumental study of the functionality of ileoanal "reservoirs"].
Twenty-five patients with ileo-anal "reservoir" have been evaluated by clinical examination, manometry, proctography, endoscopy and biopsy, at least six months from the closure of ileostomy. 80% of them presented with a satisfactory condition, although only one third reached a normal function; 20% suffered for one or more dysfunctions which lead to a variable degree of social handicap. The most frequent dysfunctions were incontinence (13 patients), urgency (10), frequency (9), pouchitis (6), incapacity to evacuate (2). The mean values at manometry showed a halved anal tone, a slightly impaired external sphincter, a halved compliance of the pouch in comparison to normal rectum. Radiology demonstrated that half the patients with dysfunctions had a reduced motility of the pouch and anomalies in sphincter coordination. Endoscopy and biopsies demonstrated inflammation in 12 patients and 6 of them developed an acute pouchitis. From a general point of view, apart from particular conditions, it has been impossible to correlate clinical dysfunctions with a specific abnormality at the instrumental evaluation. Therefore, while good results are assumed to be due to a normally restored anatomical and motility condition, we must recognize that most clinical dysfunctions are not univocally correlated to abnormalities of the pouch or of the sphincteric apparatus.
Frego
M
M
Istituto di Clinica Chirurgica I, Università degli Studi di Padova.
Angriman
I
I
Tropea
A
A
D'Amico
D
D
D001003:Anal Canal / Q000503:physiopathology; D001706:Biopsy; D003106:Colon / Q000000981:diagnostic imaging / Q000473:pathology; D003113:Colonoscopy; D005069:Evaluation Studies as Topic; D005242:Fecal Incontinence / Q000175:diagnosis; D005500:Follow-Up Studies; D006801:Humans; D008365:Manometry; D011183:Postoperative Complications / Q000175:diagnosis; D016737:Proctocolectomy, Restorative; D011859:Radiography
Studio clinico e strumentale sulla funzionalità dei "reservoirs" ileo-anali.