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Related Experiment Videos

Effect of anorectal eversion during restorative proctocolectomy on anal sphincter function

W G Lewis1, P J Holdsworth, P M Sagar

  • 1University Department of Surgery, General Infirmary at Leeds, UK.

The British Journal of Surgery
|January 1, 1993
PubMed
Summary

Restorative proctocolectomy using the eversion technique preserves anal sphincter function. This surgical approach for ulcerative colitis patients maintains continence without significant impairment of anorectal function.

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Area of Science:

  • Colorectal Surgery
  • Gastroenterology
  • Anorectal Physiology

Background:

  • Restorative proctocolectomy is a key surgical option for ulcerative colitis.
  • The eversion technique for ileal pouch-anal anastomosis avoids anal mucosa resection.
  • Potential impacts on anorectal function require thorough investigation.

Purpose of the Study:

  • To evaluate the effect of restorative proctocolectomy with eversion technique on anorectal function.
  • To assess changes in anal sphincter pressure, length, and sensation post-surgery.
  • To determine the impact on patient continence after this specific surgical approach.

Main Methods:

  • Twenty-six patients underwent restorative proctocolectomy with end-to-end ileal pouch-anal anastomosis via eversion.

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  • Anorectal function tests, including maximum resting and squeeze pressures, sphincter length, and sensory thresholds, were performed pre- and post-operatively.
  • Follow-up assessments were conducted at a median of 8 months.

    • Main Results:

    • A statistically significant decrease in maximum resting anal pressure was observed post-operatively (P=0.002).
    • Maximum squeeze pressure and anal sphincter length showed no significant changes.
    • Anal canal sensory thresholds remained unaffected, and 25 out of 26 patients maintained continence.

    Conclusions:

    • Restorative proctocolectomy employing the eversion technique does not significantly impair anal sphincter function.
    • The surgical method preserves anorectal physiology and maintains a high degree of fecal continence.
    • This technique is a viable option for patients requiring restorative proctocolectomy.