[The 3rd national workshop on defecography: the functional radiology of (neo) rectal ampullae (ileal reservoir, colo-anal anastomosis, continent perineal colostomy)].
A survey was made in 13 Italian centers with a questionnaire concerning the (a) indications, (b) postoperative complications, (c) functional results and (d) diagnostic imaging modalities related to the making of an ileal or colonic (neo) rectum. Ulcerative colitis (100%), familial polyposis (61.5%) and Crohn's disease (15.3%) were the most common indications for an ileal pouch; rectal cancer (7.96%), chronic inflammatory diseases (15.3%), diverticulosis, rectal prolapse, redundant colon and imperforate anus (7.6% each) were the most common indications for a colonic pouch. Postoperative complications included pelvic abscess (14%), sinus tract/dehiscence (10%) and bowel obstruction (9%). When compared with the S and W variants, the J-shaped ileoanal pouch proved superior because urgency and fecal retention rates were lower (18.4% vs. 44.4% and 23% vs. 28.6%, p < 0.01 and p < 0.05, respectively), despite slightly more frequent staining episodes (15.8% vs. 11.1%; p < 0.05). As for colonic ampullae, fecal retention and provoked evacuation were more frequent in the J pouch and after gracileplasty; urgency and incontinence in the straight colo-anal anastomosis (33.3% vs. 22.2% and 41.6% vs. 33.3%, respectively). The functional outcome was assessed by anal endosonography (available in 4/13 centers), defecography and anorectal manometry. Abnormal findings included: (a) reduced capacity, barium leakage, anal gaping, sphincter damage (urgency and incontinence); (b) barium retention, pouch dilatation, split evacuation, knobs and strictures (fecal retention).
Piloni
V
V
Istituto Geriatrico, Ancona.
Pieri
L
L
Pomerri
F
F
Pittarello
F
F
Salvetti
M
M
Leo
E
E
Brusori
S
S
Bassi
F
F
Rottoli
M L
ML
Pucciani
F
F
Lazzini
S
S
Minotto
R
R
Postiglione
C
C
Sacco
P
P
Bernini
A
A
Menchinelli
S
S
Pescatori
M
M
Marmorale
C
C
Frascio
M
M
Pitto
G
G
Grassi
R
R
Genovesi
N
N
Basile
M
M
Anselmetti
G
G
Amadio
L
L
D003672:Defecation; D006801:Humans; D007558:Italy; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D016737:Proctocolectomy, Restorative / Q000009:adverse effects / Q000379:methods; D012007:Rectum / Q000000981:diagnostic imaging* / Q000503:physiopathology; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography