| Project/Area Number |
09671323
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Digestive surgery
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| Research Institution | Nagasaki University |
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Principal Investigator |
NAKAGOE Tohru First Department of Surgery, School of Medicine, Nagasaki University, Associate professor, 医学部, 助教授 (40188917)
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| Co-Investigator(Kenkyū-buntansha) |
KUROSAKI Nobuko First Department of Surgery, Nagasaki University Hospital, Associate professor, 医学部・附属病院, 講師 (50253646)
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| Project Period (FY) |
1997 – 2000
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| Project Status |
Completed (Fiscal Year 2000)
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| Budget Amount *help |
¥3,000,000 (Direct Cost: ¥3,000,000)
Fiscal Year 2000: ¥200,000 (Direct Cost: ¥200,000)
Fiscal Year 1999: ¥200,000 (Direct Cost: ¥200,000)
Fiscal Year 1998: ¥200,000 (Direct Cost: ¥200,000)
Fiscal Year 1997: ¥2,400,000 (Direct Cost: ¥2,400,000)
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| Keywords | rectal cancer / ileocolonic interposition pouch / low anterior resction / 回盲部間置術 |
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| Research Abstract |
BACKGROUND/AIM : Ileocolonic interposition pouch (IIP) is a new candidate for pouch operation for rectal cancer patients, in which an ileocolonic segment is interposed between anal canal and descending colon after rectal cancer resection with total mesorectal excision. The aim of this study was to compare postoperative anal function utilizing IIP with those of the conventional straight type reconstruction (end-to-end sigmoid-anal canal anastomosis).
PATIENTS AND METHODS : Seventeen rectal cancer patients who underwent IIP between 1995 and 200 were prospectively studied (IIP group). Twenty-six rectal caner patients who underwent conventional straight type reconstruction during same period served as the control group (Straight group). The operative outcomes, bowel movement, colonic transit time (using by SITZMARKS【○!R】), and manometric study between two groups were compared.
RESULTS : The clinicopathological features of tumors and operative morbidity between two groups did not differ. Mean times of bowel movement at 1/3/6/12/24/36/48 month (s) after surgery is as follows : 9.4/6.3/5.6/4.7/3.9/ 3.2/3.7 (per day) in patients with IIP group and 11.6/7.6/6.4/5.1/4.1/3.9/4.5 (per day) in patients with Straight group, respectively. The mean (±standard deviation) of colonic transit time (half-dose) is as follows : 31.2 (±17.6) hours in patients with IIP group ; 65.1 (±38.8) hours in patients with Straight group ; 28.8 (±9.5) hours in healthy subjects. The manometric studies between two groups did not differ.
CONCLUSION : The reconstruction using IIP may decrease the times of bowel movement and normalized the colonic transit time after surgery, forming an attractive alternative pouch operation in rectal cancer patients. The IIP may serve attractive features as follows : 1) preservation of nerve supply to pouch ; 2) no mobilization around the splenic flexure ; 3) intact pouch wall ; 4) no diversion.
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