Studies on adaptation mechanism and effects of ileal reservoir following total colectomy
| Project/Area Number |
06671320
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
Digestive surgery
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| Research Institution | Kinki University |
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Principal Investigator |
KOH Kenzo Kinki University, 医学部, 講師 (00183327)
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| Co-Investigator(Kenkyū-buntansha) |
KAYAMA Hitoshi Kinki University, 医学部, 助手 (30247994)
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| Project Period (FY) |
1994 – 1995
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| Project Status |
Completed (Fiscal Year 1995)
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| Budget Amount *help |
¥1,500,000 (Direct Cost: ¥1,500,000)
Fiscal Year 1995: ¥900,000 (Direct Cost: ¥900,000)
Fiscal Year 1994: ¥600,000 (Direct Cost: ¥600,000)
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| Keywords | total colectomy / J-pouch reservoir / postperative adaptation / bowel function / luctulose hydrogen breath test / intestinal transit time / PYY / colonization / J pouch reservon / 胃排出能 / Lactulose-hydrogen breath test / GLI / 回腸嚢 / 嫌気性菌 / HBT |
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| Research Abstract |
In a clinical study, we examined the clinical assessment of bowel function and lactulose hydrogen breath test in 14 patients after total colectomy. All patients within one year after ileostomy closure had 'poor' function and showed no increase of hydrogen breath gas concentration. 10 of 12 patients more than one year showed increase of hydrogen breath gas concentration, and 8 of them had 'fair' function. The intestinal transit time (TT) in 'poor' group was shorter than in 'fair' group and control (p<0.05). The increase of hydrogen breath gas suggests changes of bacterial flora and colonization of the ileum.
In an experimental study, we performed end to end (E-E ; n-5) or J-pouch (J-P ; n=5) anastomosis after resection of tatal colon and the rectum 3 cm above the peritoneal reflexion. Gastrointestinal motility with strain gauge force transducers and transit time with barium meal under the fluoroscopy were recorded 6 months after total colectomy. Then, histological changes of resected ileum in J-P and E-E vs control (normal ileum ; n=5) were measured with hematoxylin-eosin and anti-PYY immunohistochemical stains. Propagation rate of interdigestive migrating complex (IMC) was significantly lower in J-P (64.8*3.2%) than in E-E (98.6*1.2%), (p<O.001). TT in E-E (138*10 min) was shorter (p<O.O5) than in J-P (189*26 min). There was no difference in length of villi but length of crypts in J-P (0.59*0.08 mm) was longer than that in E-E (0.27*0.09 mm) and normal ileum (034*0.07 mm) (p<O.O1). Total number of PYY postitve cells in J-P (168*18) was significantly increased than that in E-E (111*16) and control (103*14) (p<O.O5).
Thus, increase of PYY positive cells in J-pouch inhibited gastrointestinal motility and transit. Delayed transit time and crypts elongation braught intestinal adaptation that assists the absorption of luminal contents. Therefore, it suggested that J-pouch reservoir had advantage to ileo-proctostomy following total colectomy.
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Report
(3 results)
Research Products
(12 results)
