Abstract
Background: In 2017, we reported laparoscopic total proctocolectomy with J pouch anal anastomosis, which was created at the dentate line by our original procedure using staplers, Triple Stapling Resection and J pouch Anal Stapling Anastomosis (TSRJASA), for ulcerative colitis (UC) patients. UC patients have undergone TSRJASA since it was introduced in our institution. However, the feasibility and usefulness of TSRJASA for UC patients has not been elucidated.Methods: From January 2014 to December 2018, fourteen patients with ulcerative colitis, including three cases of concomitant cancer, who underwent TSRJASA were enrolled in this study. Anal manometry was performed using the Pock Monitor GMMS-100 system (STAR MEDICAL, INC., Tokyo, Japan) one year and two years after surgery. Maximum resting pressure, maximum squeeze pressure, and the length of the high-pressure zone were measured. Fecal incontinence was evaluated using the Wexner incontinence questionnaire.Results: J pouch anal anastomosis was created at the dentate line in all patients. In a manometric examination two years after surgery, maximum resting pressure was 75.3 (54-88) mmHg, maximum squeeze pressure was 125.0 (90-160) mmHg, and the length of the high-pressure zone was 39.6 (35-42) mm. Wexner score was 2.8 (1-4).Conclusion: TSRJASA seems to be a useful procedure for UC patients given its acceptable defecation function.
Pathophsiological Study on Terminal Motor Latency in the Pudendal Nerve for Ulcerative Colitis after Ileal J Pouch-Anal Anastomosis with or without Soiling.