title: Stricture of ileo-anal J pouch anastomosis increased the intensity of pouchitis in an experimental rat model.
abstract: BACKGROUND
  Pouchitis appears to be the most common complication after restorative proctocolectomy.
  
  
  METHODS
  In experimental models we investigated the correlation between the width of anastomosis and the frequency of pouchitis. Twenty-three Wistar rats underwent restorative proctocolectomy under pentobarbital anesthesia. Normal width anastomosis was performed in 11 animals (Group I). In the remaining 12 animals (Group II) the diameter of anastomosis was reduced by 50%. All animals were sacrificed and the pouch mucosa was histologically (Moskowitz score) and immunohistochemically (IL-1, IL-6, IL-10, IL-12 expression) examined.
  
  
  RESULTS
  Morphological assessment of pouchitis symptoms based on Moskowitz scale revealed considerably more severe inflammation (p=0.0079) in the animals from Group II than in the rats from Group I. The expressions of investigated cytokines, assessed qualitatively in histopathological examination, were higher in rats with narrow anastomosis in comparison with animals with normal anastomosis.
  
  
  CONCLUSIONS
  The stricture of anastomosis increases the intensity of pouchitis and stimulates the production of interleukins. It seems that anastomotic stricture plays an important role in the development of pouchitis.
authors.affiliation: Department of General Surgery, Gastroenterological Oncological Surgery and Plastic Surgery, K. Marcinkowski University of Medical Sciences, Poznan, Poland. tbanasiewicz@op.pl
authors.forename: Tomasz
authors.initials: T
authors.lastname: Banasiewicz
authors.forename: Jarosław
authors.initials: J
authors.lastname: Walkowiak
authors.forename: Sławomira
authors.initials: S
authors.lastname: Drzymała-Czyż
authors.forename: Maciej
authors.initials: M
authors.lastname: Borejsza-Wysocki
authors.forename: Przemysław
authors.initials: P
authors.lastname: Majewski
authors.forename: Maciej
authors.initials: M
authors.lastname: Biczysko
authors.forename: Zoran
authors.initials: Z
authors.lastname: Stojcev
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Herzig
authors.forename: Michał
authors.initials: M
authors.lastname: Drews
mesh_terms: D001003:Anal Canal / Q000473:pathology* / Q000601:surgery*; D000714:Anastomosis, Surgical / Q000009:adverse effects; D000818:Animals; D039021:Colonic Pouches / Q000009:adverse effects*; D003251:Constriction, Pathologic; D004195:Disease Models, Animal; D007082:Ileum / Q000473:pathology* / Q000601:surgery*; D007150:Immunohistochemistry; D007378:Interleukins / Q000378:metabolism; D008297:Male; D019449:Pouchitis / Q000209:etiology* / Q000473:pathology; D051381:Rats; D017208:Rats, Wistar
chemical_list: D007378:Interleukins