J.Jpn. Surg. Soc.. 81(1): 61-77, 1980
Original article
DEVELOPMENT OF NEW PROCEDURE FOR TOTAL COLECTOMY, MUCOSAL PROTECTOMY AND ILEOANO STOMY AND ITS PRELIMINARY RESULT
|
1) Second Department of Surgery, and Polyposis Center, Tokyo Medical and Dental University J. Ustunomiya1), T. Iwama1), N. Imajo1), S. Matsuo1), S. Sawai1), T. Okamura1), S. Hamada1), K. Uehara1), T. Inoue1), T. Ichikawa1), T. Fujihata1), J. Matsumura1), S. Togo1), S. Mitaka1), M. Yasuda1), K. Yaegashi1), R. Hirayama1), K. Asano1), T. Nakamura2), T. Sakai2), T. Muraoka3) |
The essential points of our technique are: 1. Total removal of large intestinal mucosa down to the dentate line in most of the cases. 2. For preservention of pelvic sepsis, a temporary defunctionning ileostomy for 3 monthes, intraoperative rectal irrigation and effective drainage of the rectal cuff are used. 3. For preservation of the rectoanal function, the following measures are recommended: A long rectal muscular cuff is created for preservation of rectal neuromuscular function using the mucosal stripping by the rectal internal stent method. Ileoanal anastomosis and creation of an ileal reservoir are accomplished using one of the following three different methods: An end to end anastomosis without reservoir an end to end anastomosis with isoperistaltic double barreled reservoir outside of the cuff and an end to side anastomosis with an antiperistaltic ileal loop reservoir inside the cuff.
In five cases, the operation was accomplished by closing the loop ileostomy for more than three monthes. All of them show good fecal continence with less than five bowel movements per day. The stool is semiformed. All have returned to normal activity. Two students are active in sports.
To read the PDF file you will need Adobe Reader installed on your computer.