American journal of surgery · 1996
The ileocecal reservoir for rectal replacement in complicated radiation proctitis.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод пока не подготовлен
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von Flüe M O, Degen L P, Beglinger C, Harder F H
Аннотация
BACKGROUND/AIMS: Total rectal resection is the radical treatment method for radiation proctitis complications. Park's straight colo-anal reconstruction to replace the rectum often impairs anal continence, increases stool frequency, and causes imperative urgency. We developed and assessed a colo-anal reconstruction (ileocecal reservoir) after resection of radiation-damaged rectum.
METHODS: An ileocecal segment was isolated on its lymphovascular pedicel, rotated counterclockwise, and reanastomosed at the dentate line. This provided a neorectal segment with intact intrinsic and extrinsic nerve and lymphovascular supply. We evaluated the safety, defecation quality, and anorectal function of this neorectum in two radiation-injured patients when compared with 15 patients after total mesorectal excision without radiation damage.
RESULTS: No perioperative morbidity related to this technique was observed. Neorectal patients showed good defecation quality with maximal tolerable volumes, compliances, and anal manometry comparable with patients without radiation injury.
CONCLUSIONS: This rectal replacement technique permits good defecation quality and excellent anorectal function.
METHODS: An ileocecal segment was isolated on its lymphovascular pedicel, rotated counterclockwise, and reanastomosed at the dentate line. This provided a neorectal segment with intact intrinsic and extrinsic nerve and lymphovascular supply. We evaluated the safety, defecation quality, and anorectal function of this neorectum in two radiation-injured patients when compared with 15 patients after total mesorectal excision without radiation damage.
RESULTS: No perioperative morbidity related to this technique was observed. Neorectal patients showed good defecation quality with maximal tolerable volumes, compliances, and anal manometry comparable with patients without radiation injury.
CONCLUSIONS: This rectal replacement technique permits good defecation quality and excellent anorectal function.