J.Jpn. Surg. Soc.. 85(10): 1349-1358, 1984
Original article
PATHOPHYSIOLOGICAL STUDY OF THE ILEUM AFTER TOTAL COLECTOMY IN COMBINATION WITH MUCOSAL PROTECTOMY AND ILEOANOSTOMY
ーTHE ALTERATION OF WATER AND ELECTROLYTE ABSORPTION AT THE ILEUM AFTER ILEOANOSTOMY
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Second Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan Shigeo Sawai |
Using dialysis method, we evaluated the alteration of the ability to absorb water and electrolytes at the ileum after ileoanostomy in 12 patients with adenomatosis coli and 4 patients with ulcerative colitis, and compared the result with fecal volume and content to investigate compensatory function of the small intestine after total colectomy.
Volume of water absorbed at the ileum was 0.389g in an average soon after the first stage operation but gradually increased after the intestinal continuity was restored following the second stage operation with the volume of 0.666g after 1 year and 0.702g after 2 years (1.8 fold increase).
Fecal volume excreted was 852g/ day in an average after loop ileostomy (first stage operation) but decreased to 316g/day in a year after the second stage operation with simultaneous change of fecal character from watery to solid. The decrease of fecal volume was inversely correlated with the increase of the volume of water absorbed at the ileum (p＜0.001).
The ability to absorb electrolytes increased after the second stage operation compared to that of after the first stage operation but subsequently minimal change was noted. And the absorption pattern was different from that of the large intestine.
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