J.Jpn. Surg. Soc.. 82(11): 1366-1376, 1981

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Original article

ANORECTAL FUNCTION AFTER TOTAL COLECTOMY, MUCOSAL PROCTECTOMY AND ILEOANAL ANASTOMOSIS

Anorectal manometric study was performed on 22 cases (17 with adenomatosis coli and 5 cases with ulcerativec olitis) before and after total colectomy, mucosal proctectomy and ileoanal anastomosis of the procedure deviced by Utsunomiya et al. in which the rectal mucosa was stripped out beginning at the level above peritoneal floor and down to just above the dentate line. In 15 cases out of them, anorectal monometric parameters were compared with clinical foecal function. All of 11 patients in whith the maximum anal cannal pressure at rest was more than 60cm H₂O showed excellent or good foecal function whereas all of 4 patients with less than 50cm H₂O were evaluated as fair or failure. The rectoanal reflex was found to be positive in 7 patients out of which 6 showed excellent or good clinical value. Other parameters such as the voluntary anal contructing prssure, the rectal pressure the type of anal rhythmical wave did not show any significant correlation with the clinical value. It was concluded that the maximum resting anal cannal pressure at rest and the anorectal reflex were the important anorectal manometric parameters significantly reflecting clinical result and a preservation of the rectal muscular cuff as well as the anal internal sphincter during the operation is essential for obtainning a favorable postoperative foecal function.

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