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  • 1
    ISSN: 1530-0358
    Keywords: Ileoanal anastomosis ; Continence ; Anal pressure ; Internal sphincter relaxation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This study was done to determine the effect of the direct ileal pouch-anal anastomosis upon pressure and sensory components of the anal canal and ileal pouch. These findings were related to postoperative continence. Thirty-three patients with ileal pouch-anal anastomosis (25 continent, eight with episodic minor incontinence) were studied 3±0.3 and 25±5 months after ileostomy takedown. The maximum resting pressure in the anal canal was significantly lower in patients with an imperfect result (35±5 mm Hg) than in continent patients (44±5 mm Hg) (P〈0.05). Postoperatively the maximum squeeze anal pressure was slightly greater in continent than in incontinent patients (99±8 mm Hg vs.87±7 mm Hg) (P〉0.05). The postoperative recto-(ileo-)anal inhibitory reflex was present in 27 percent. The linear correlation between strength of rectal (ileal) distension and depth resp. duration of internal sphincter relaxation as preoperatively observed disappeared postoperatively in every group of patients. Simultaneous measurements of pouch and anal pressure in patients with imperfect results revealed a reduced positive pouch anal pressure gradient compared to the continent group. This low pouch-anal pressure gradient is thought to be responsible for the increased incidence of soiling in some of our patients.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1435-2451
    Keywords: Intestinal anastomoses ; Internal splinting ; Absorbable and non-absorbable biomaterial tubes
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In einem tierexperimentellen Grundlagenversuch wurde an 80 Ratten das Prinzip der inneren Schienung problematischer intestinaler Anastomosen mit Biomaterialrohren überprüft. Eine problematische Anastomose entstand durch Zweipunktadaptation des oberen Dünndarmes. Alle Tiere der Kontrollgruppe (n =10) ohne innere Schienung verstarben bis zum zweiten postoperativen Tag. In den Behandlungsgruppen I-IV (n = 70) wurde die Dünndarmanastomose durch intraluminär plazierte, resorbierbare (Polyglactin, Kollagen, B 111) bzw. nicht resorbierbare (Polyurethan) Biomaterialrohre gesichert. Signifikant geringere Insuffizienzraten in den Behandlungs gruppen belegen die prinzipielle Effektivität dieses Verfahrens.
    Notes: Summary We performed small intestinal dissection in 80 laboratory rats. A critical anastomosis was achieved by two point adaption of small intestine with single sutures. 10 control animals receiving no intestinal splinting died within two days of operation. The remaining 70 animals underwent intestinal internal splinting with tubes of different absorbable (Polyglactine, Collagen, and B 111) and non-absorbable (Polyurethane) biomaterials. Significantly smaller leakage rates in the therapy groups proved the principle of internal splinting of complicated anastomoses in this animal model to be effective.
    Type of Medium: Electronic Resource
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