Use of the pylorus for preventing ileostomy complications. An experimental canine study.
OBJECTIVE
Conventional ileostomy, as it is well known, presents with persistent watery diarrhea, among other complications. The present-day modified methods of conventional ileostomy cannot effectively prevent these unpleasant consequences. The purpose of this study was to try to use the sphincter mechanism of the pylorus in ileostomy in dogs experimentally to prevent the above symptoms.


METHODS
Following a highly selective vagotomy, the antrum with the pylorus and a 3-cm segment of the duodenum were separated from the gastrointestinal tract along with its vasculature and innervation, and the distal duodenal end was closed. Then, the terminal loop of ileum (before an ileostomy was performed) was dissected, and the distal segment was anastomosed with the proximal end of duodenum; the proximal segment of this loop was anastomosed with the stump of the antrum. The gastrointestinal continuity was established by anastomosis of the gastric stump to the first loop of the jejunum.


RESULTS
After the procedure, the sphincter mechanism of the pylorus was preserved, and bowel movements became solid and infrequent, so a colostomy bag could be applied consistently.


CONCLUSIONS
Similarity of anatomy and physiology of the alimentary tract in dogs and human favors possible application of this procedure to humans, with better results than with conventional ileostomy.
Toubanakis
G
G
Athens University Medical School, First Department of Propedeutic Surgery, Athens, Greece.
Peveretos
P
P
Toubanakis
C
C
Golematis
B C
BC
D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D004195:Disease Models, Animal; D004285:Dogs; D005240:Feasibility Studies; D018530:Gastric Stump / Q000601:surgery*; D006801:Humans; D007081:Ileostomy / Q000009:adverse effects / Q000379:methods*; D011706:Pyloric Antrum / Q000637:transplantation*; D014629:Vagotomy, Proximal Gastric