Fecal control following pyloric valve transposition after abdominoperineal resection

The objective of this study was to learn if a transposed pyloric valve could be mobilized to the perianal area following an abdominoperineal resection and function as a replacement for the excised anal sphincter.

The study was performed in a surgical research laboratory. Eleven cats were used in the study: 9 served as experimental animals and 2 were controls. The operation involved mobilization of the pyloric valve based on an intact omental pedicle; the proximal side of the pyloric valve was anastomosed to the divided end of the left colon and the distal end of the pyloric valve was sutured to the perianal area.

The excellent healing of the pyloric valve in its ectopic position was confirmed anatomically and histologically following the sacrifice of the animals. The pyloric valve was effective in maintaining complete fecal control in 4 cats and almost complete fecal continence in 2 other cats. Three other cats developed fecal incontinence due to a perianal fistula, and 2 control cats had complete fecal incontinence.

There appears to be no anatomical or technical reason why the pyloric valve cannot be applied in the human as a replacement for an excised anal sphincter.