Hidejiro Kawahara1,2, Nobuo Omura2. 1. Department of Surgery, Kashiwa Hospital, Jikei University School of Medicine, Chiba, Japan; kawahide@outlook.jp. 2. Department of Surgery, Nishisaitama-chuo National Hospital, Saitama, Japan.
Abstract
BACKGROUND: We previously 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 long-term outcome of TSRJASA for UC patients has not been elucidated. PATIENTS AND 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 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) mm Hg, maximum squeeze pressure was 125.0 (90-160) mm Hg, and the length of the high-pressure zone was 39.6 (35-42) mm. Wexner score was 2.8 (1-4). CONCLUSION: TSRJASA is a useful procedure for UC patients given its acceptable defecation function.
BACKGROUND: We previously 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 long-term outcome of TSRJASA for UC patients has not been elucidated. PATIENTS AND 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 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) mm Hg, maximum squeeze pressure was 125.0 (90-160) mm Hg, and the length of the high-pressure zone was 39.6 (35-42) mm. Wexner score was 2.8 (1-4). CONCLUSION: TSRJASA is a useful procedure for UC patients given its acceptable defecation function.
Authors: Richard E Lovegrove; Vasilis A Constantinides; Alexander G Heriot; Thanos Athanasiou; Ara Darzi; Feza H Remzi; R John Nicholls; Victor W Fazio; Paris P Tekkis Journal: Ann Surg Date: 2006-07 Impact factor: 12.969
Authors: J S Choi; F Potenti; S D Wexner; Y S Nam; Y H Hwang; J J Nogueras; E G Weiss; A J Pikarsky Journal: Dis Colon Rectum Date: 2000-10 Impact factor: 4.585
Authors: Le Manh Cuong; Ha Van Quyet; Tran Manh Hung; Nguyen Ngoc Anh; Tran Thu Ha; Vu Van Du; Do Van Loi; Ha Huu Hoang Khai; Vu Duy Kien Journal: BMC Gastroenterol Date: 2021-07-15 Impact factor: 3.067