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. 1981 Jun;22(6):462–468. doi: 10.1136/gut.22.6.462

Restorative proctocolectomy with ileal reservoir: a pathophysiological assessment.

R J Nicholls, P Belliveau, M Neill, M Wilks, S Tabaqchali
PMCID: PMC1419259  PMID: 7262623

Abstract

A metabolic and physiological assessment was carried out in 14 patients who had undergone restorative proctocolectomy with ileal reservoir more than six months previously. The haemoglobin was normal in all but one and plasma electrolytes and serum albumin, calcium, phosphorus, and red cell folate estimations were normal in all. Five patients had low serum iron levels of whom one had an iron deficiency anaemia. The 24 hour faecal fat output was normal in all patients and there was no case of vitamin B12 malabsorption as judged by the Schilling test, although four patients had marginally low values. These were not associated with increased bacterial counts in the faeces within the reservoir and there was no evidence to support a diagnosis of stagnant loop syndrome. Inflammation of the reservoir mucosa was, however, associated with higher counts of aerobic bacteria than in cases where inflammation was absent. Subtotal villous atrophy or inflammation was seen in biopsies of the reservoir in six patients. The mean faecal output per 24 hours was 659 +/- 259 g and the mean reservoir volume was 330 +/- 78 ml. Mean resting anal canal pressure was significantly lower in patients with a mucous leakage per anum than in those without, while manometry of the reservoir showed no alteration of pressure over a period of one hour before and after a meal. A positive rectosphincteric reflex was observed in nine patients.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aylett S. O. Three hundred cases of diffuse ulcerative colitis treated by total colectomy and ileo-rectal anastomosis. Br Med J. 1966 Apr 23;1(5494):1001–1005. doi: 10.1136/bmj.1.5494.1001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. BEAL R. W., SKYRING A. P., MCRAE J., FIRKIN B. G. THE ANEMIA OF ULCERATIVE COLITIS. Gastroenterology. 1963 Nov;45:589–603. [PubMed] [Google Scholar]
  3. Fonkalsrud E. W. Total colectomy and endorectal ileal pull-through with internal ileal reservoir for ulcerative colitis. Surg Gynecol Obstet. 1980 Jan;150(1):1–8. [PubMed] [Google Scholar]
  4. Gadacz T. R., Kelly K. A., Phillips S. F. The continent ileal pouch: absorptive and motor features. Gastroenterology. 1977 Jun;72(6):1287–1291. [PubMed] [Google Scholar]
  5. Gorbach S. L., Plaut A. G., Nahas L., Weinstein L., Spanknebel G., Levitan R. Studies of intestinal microflora. II. Microorganisms of the small intestine and their relations to oral and fecal flora. Gastroenterology. 1967 Dec;53(6):856–867. [PubMed] [Google Scholar]
  6. Jones F., Munro A., Ewen S. W. Colectomy and ileorectal anastomosis for colitis: report on a personal series, with a critical review. Br J Surg. 1977 Sep;64(9):615–623. doi: 10.1002/bjs.1800640903. [DOI] [PubMed] [Google Scholar]
  7. Kock N. G., Darle N., Hultén L., Kewenter J., Myrvold H., Philipson B. Ileostomy. Curr Probl Surg. 1977 Aug;14(8):1–52. doi: 10.1016/s0011-3840(77)80065-8. [DOI] [PubMed] [Google Scholar]
  8. Kock N. G. Intra-abdominal "reservoir" in patients with permanent ileostomy. Preliminary observations on a procedure resulting in fecal "continence" in five ileostomy patients. Arch Surg. 1969 Aug;99(2):223–231. doi: 10.1001/archsurg.1969.01340140095014. [DOI] [PubMed] [Google Scholar]
  9. Lane R. H., Parks A. G. Function of the anal sphincters following colo-anal anastomosis. Br J Surg. 1977 Aug;64(8):596–599. doi: 10.1002/bjs.1800640820. [DOI] [PubMed] [Google Scholar]
  10. Nilsson L. O., Andersson H., Hultén L., Jagenburg R., Kock N. G., Myrvold H. E., Philipson B. Absorption studies in patients six to 10 years after construction of ileostomy reservoirs. Gut. 1979 Jun;20(6):499–503. doi: 10.1136/gut.20.6.499. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Parks A. G., Nicholls R. J., Belliveau P. Proctocolectomy with ileal reservoir and anal anastomosis. Br J Surg. 1980 Aug;67(8):533–538. doi: 10.1002/bjs.1800670802. [DOI] [PubMed] [Google Scholar]
  12. Parks A. G., Nicholls R. J. Proctocolectomy without ileostomy for ulcerative colitis. Br Med J. 1978 Jul 8;2(6130):85–88. doi: 10.1136/bmj.2.6130.85. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Philipson B., Brandberg A, Jagenburg R., Kock N. G., Lager I., Ahrén C. Mucosal morphology, bacteriology, and absorption in intra-abdominal ileostomy reservoir. Scand J Gastroenterol. 1975;10(2):145–153. [PubMed] [Google Scholar]
  14. Schjonsby H., Halvorsen J. F., Hofstad T., Hovdenak N. Stagnant loop syndrome in patients with continent ileostomy (intra-abdominal ileal reservoir). Gut. 1977 Oct;18(10):795–799. doi: 10.1136/gut.18.10.795. [DOI] [PMC free article] [PubMed] [Google Scholar]

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