Related Experiment Video
Updated: Oct 19, 2025

Author Spotlight: Developing a Rat Model for Pouchitis Research and Treatment
Published on: May 31, 2024
Defecation Function After Laparo-Assisted Restorative Proctocolectomy with Ileal Pouch Anal Anastomosis for
Kiyotaka Hagihara1,2, Ryota Mori1, Yuki Sekido1
1Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Japan.
Background:
Defecation status is an important determinant of quality of life. Previous studies showed that postoperative defecation disorders occurred after open surgery for ulcerative colitis (UC), but few have investigated defecation status after laparo-assisted surgery. The added precision and magnification provided with laparo-assisted surgery should lead to less damage to the anal sphincter muscle. This study investigated defecation function after a laparo-assisted restorative proctocolectomy (RPC) with ileal pouch anal anastomosis (IPAA). We also clarified factors that worsened defecation status.
Methods:
This retrospective study included 57 patients who underwent laparo-assisted RPC with IPAA for UC from January 2000 to May 2019. At 1 year after surgery, functional outcomes were evaluated with the Kirwan classification and Wexner score. Risk factors for poor defecation status were investigated with multiple regression.
Results:
At 1 year after surgery, the median Kirwan classification score was 2 and the median Wexner score was 8. Defecation disorder was observed in 19 (33.3%) patients, according to the Kirwan classification, and 15 (26.3%) patients, according to the Wexner score. Hand-sewn IPAA was associated with defecation disorder (P = .04), evaluated with the Kirwan classification. Hand-sewn IPAA (P = .01), older age (P = .03), high body mass index (P = .04), and the surgical indication (cancer/dysplasia; P = .03) were significantly associated with defecation disorder, evaluated with the Wexner score. The multivariable analysis showed that hand-sewn IPAA was an independent risk factor (P = .049; odds ratio: 4.99; 95% confidence interval: 1.0-28.39).
Conclusions:
We found that hand-sewn IPAA was a risk factor for defecation disorders after laparo-assisted RPC for UC.
Related Concept Videos
Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Feces Formation and Defecation
The mass peristalsis then pushes the feces into the rectum, which stretches the rectal walls to activate...
Assessment of the Rectum and Anus
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
Appendicitis-II: Diagnostic Studies and Management
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Physiology of the Gastrointestinal System III: Elimination

