title: Ano-neorectal function using manometry on patients after restorative proctocolectomy and ileal J-pouch anal anastomosis for ulcerative colitis in children.
abstract: OBJECTIVE
  The purpose of this study was to clarify the ano-neorectal functions in pediatric patients with soiling at a short period and without soiling at a long period after restorative colectomy and ileal J-pouch anal anastomosis (IPAA) for ulcerative colitis (UC).
  
  
  METHODS
  Ten patients after IPAA for UC in childhood were mamometrically studied, aged 10 to 16 years (mean, 13.9 years). Patients after IPAA with ileostomy closure were studied at 6 months (Group A; all patients had soiling) and 3 years after ileostomy closure (Group B; all patients showed continence). Group C served as controls and consisted of 12 subjects (aged 12 to 16 years, mean, 14.8).
  
  
  RESULTS
  Maximum anal sphincter pressure at rest and maximum anal sphincter pressure during voluntary contraction were significantly lower in group A than in groups B and C. Minimum neorectal sensory threshold volume in group A was significantly higher than in groups B and C (p<0.01). Maximum neorectal tolerated threshold volumes and neorectal compliances, and positive rates of neorectoanal inhibitory reflex, showed no significant difference among the groups.
  
  
  CONCLUSIONS
  Patients with soiling at 6 months after IPAA showed anal sphincter dysfunction and neorectal sensory dysfunction. The IPAA may cause damage to the ano-neorectal apparatus during rectal mobilization due to the short rectal cuff and mucosectomy.
authors.affiliation: Department of Surgery, Nippon Dental University School of of Life Dentistry, Tokyo, Japan. rtomita-ndus@mvg.biglobe.ne.jp
authors.forename: Ryouichi
authors.initials: R
authors.lastname: Tomita
authors.forename: Taro
authors.initials: T
authors.lastname: Ikeda
authors.forename: Shigeru
authors.initials: S
authors.lastname: Fujisaki
authors.forename: Kiminobu
authors.initials: K
authors.lastname: Sugito
authors.forename: Kenichi
authors.initials: K
authors.lastname: Sakurai
authors.forename: Tsugumichi
authors.initials: T
authors.lastname: Koshinaga
authors.forename: Masahiko
authors.initials: M
authors.lastname: Shibata
mesh_terms: D000293:Adolescent; D001003:Anal Canal / Q000294:innervation / Q000601:surgery*; D016022:Case-Control Studies; D002648:Child; D003093:Colitis, Ulcerative / Q000601:surgery*; D039021:Colonic Pouches / Q000009:adverse effects; D003672:Defecation; D005242:Fecal Incontinence / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008365:Manometry; D011237:Predictive Value of Tests; D011312:Pressure; D016737:Proctocolectomy, Restorative / Q000009:adverse effects; D012007:Rectum / Q000294:innervation / Q000601:surgery*; D012018:Reflex; D012684:Sensory Thresholds; D013997:Time Factors; D016896:Treatment Outcome