| Co-Investigator(Kenkyū-buntansha) |
SAKANOUE Youichirou Hyogo College of Medicine, Assistant, 医学部, 助手 (00187030)
KUSUNOKI Masato Hyogo College of Medicine, Assistant, 医学部, 助手 (50192026)
YAMAMURA Takehira Hyogo College of Medicine, Assistant professor, 医学部, 助教授 (90068510)
KUROKI Teruyuki Hyogo College of Medicine, Assistant (70205235)
KUSUHARA Kiyoshi Hyogo College of Medicine, Assistant (60205086)
名取 博之 兵庫医科大学, 医学部, 助手
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| Budget Amount *help |
¥6,900,000 (Direct Cost: ¥6,900,000)
Fiscal Year 1990: ¥2,100,000 (Direct Cost: ¥2,100,000)
Fiscal Year 1989: ¥2,200,000 (Direct Cost: ¥2,200,000)
Fiscal Year 1988: ¥2,600,000 (Direct Cost: ¥2,600,000)
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| Research Abstract |
Studies on pathophysiology after total colectomy, mucosal proctectomy and ileoanal anastomosis J. Utsunomiya, M. D., T. Yamamura, M. D., M. Kusuoniki, M. D., T. Kuroki, M. D., H. Natori, M. D., Y. Sakanoue, M. D., and K. Kusuhara, M. D. (Second Dept. of Surgery, Hyogo College of Medicine)
Aims of the study are to understand physiological background of bowel function and to clarify metabolic alternation in the patient after ileoanal anastomosis (IAA) in order to establish the practical procedure, which can provide the quality of life acceptable to the patients. The J-pouch anal anastomosis that had been developed by Utsunomiya J. in Tokyo through his experiences on 49 cases including 11 ulcerative colitis (UC) and 38 adenomatous polyposis coli (APC) since 1979 were further improved after 1983 in Hyogo to accumulate a new series of 94 patients (56 UC, 36 APC and 2 others). The patients with the muscular cuff that were preserved on the subperitoneal lower rectal portion (the medium cuff) w
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ere found to show a superior clinical functional result as well as better preserved resting and squeeze anal pressure comparing with those with the "minimum" rectal cuff in which the cuff was excised above the levator. For succeeding in such an extensive mucosectomy, the procedure which was devised by us included the "forceps coagulating technique" at the prone jackknife position. Hemodynamic study revealed no significant demerit during changing position of the patient. The original J-pouch with bilateral blood supplies was found to have a 24% increase in circulating blood volume in the pouch apex comparing with the short J-pouch that was created by dividing the ileocolic artery. The criteria for psychological, clinical as well as physiological aspects have been developed for objective comparative study on the late result. The metabolic states of water, electrolytes and bile acids in the patients with IAA were found to be situated in between those of the patients with terminal ileostomy and of the individual with a natural anal excretion. Less
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