title: Functional and manometric outcomes after redo-ileal pouch anal anastomosis in patients with ulcerative colitis.
abstract: OBJECTIVE
  To retrospectively analyze manometric findings in patients with ulcerative colitis who underwent redo-ileo anal anastomosis for pouch-related complications.
  
  
  METHODS
  Functional and anal manometric parameters were analyzed before, immediately after, and 6 months after the procedure in 17 patients who underwent redo-ileo anal anastomosis between 2001 and 2012.
  
  
  RESULTS
  Of the 17 patients, 13 showed stoma closure and 9 have maintained gastrointestinal continuity with functional pouches. Manometric findings were similar before and immediately after redo-ileo anal anastomosis, including length of high-pressure zone (p = 0.11) and maximum resting and (p = 0.060) squeezing (p = 0.69) pressures, but maximum resting pressure improved significantly 6 months later (p = 0.021). Univariate analysis showed that ulcerative colitis duration <3 years before ileo anal anastomosis (p = 0.0073), interval between pouch-related complications and ileo anal anastomosis <2 years (p = 0.040), and persistent abscess before diversion ileostomy (p = 0.0024) were significant risk factors for pouch failure after redo-ileo anal anastomosis.
  
  
  CONCLUSIONS
  Although maximum resting pressure was significantly reduced 3 months after redo-ileo anal anastomosis, it returned to preoperative levels after 6 months. The length of the high-pressure zone and the maximum squeezing pressure were not affected by this procedure.
authors.affiliation: Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Mie, Japan.
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Araki
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Okita
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Fujikawa
authors.forename: Keiichi
authors.initials: K
authors.lastname: Uchida
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Mohri
authors.forename: Masato
authors.initials: M
authors.lastname: Kusunoki
mesh_terms: D000293:Adolescent; D000328:Adult; D001003:Anal Canal / Q000601:surgery*; D000704:Analysis of Variance; D000714:Anastomosis, Surgical / Q000379:methods; D002648:Child; D015331:Cohort Studies; D003093:Colitis, Ulcerative / Q000473:pathology / Q000601:surgery*; D039021:Colonic Pouches / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000601:surgery*; D053208:Kaplan-Meier Estimate; D008297:Male; D008365:Manometry / Q000379:methods*; D008875:Middle Aged; D012372:ROC Curve; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult