1995 Fiscal Year Final Research Report Summary
Physiological Study on Anal Dysfunction after Large Bowel Resection with Special Refernce to Anorectal Pressure, Intestinal Transit, and Rectal Evacuation
| Project/Area Number |
06671302
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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 | Dokkyo University School of Medicine |
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Principal Investigator |
OYA Masatosi Faculty of Medicine, School Medicine Dokkyo University, Lecturer, 医学部, 講師 (80254944)
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| Co-Investigator(Kenkyū-buntansha) |
AKIYAMA Hiroshi Faculty of Medicine, School Medicine Dokkyo University, Associate Surgeon, 医学部, 助手 (10222548)
HIROSE Kiyotaka Faculty of Medicine, School Medicine Dokkyo University, Associate Surgeon, 医学部, 助手 (30265326)
ISHII Yuji Faculty of Medicine, School Medicine Dokkyo University, Associate Surgeon, 医学部, 助手 (80254952)
KOMATSU Junji Faculty of Medicine, School Medicine Dokkyo University, Associate Surgeon, 医学部, 助手 (20245096)
NAKAMURA Tetsuro Faculty of Medicine, School Medicine Dokkyo University, Associate Surgeon, 医学部, 助手 (50254991)
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| Project Period (FY) |
1994 – 1995
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| Keywords | Colorectal Surgery / Anal function / Large Bowel Motility / Anorectal Manometryt / Colonic Transit / Defecography |
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| Research Abstract |
1. In 22 patients who underwent low anterior resection (LAR) for rectal cancer, anorectal manometry and sensory tests were carried out both preoperatively and postoperatively. The length of high pressure zone and rectal capacity were reduced postoperatively. Patients having an anastomosis close to the anal margin and those having a small neorectal capacity had a poor postoperative anal function. Using a multiple regression analysis, the age, the distance of the anastomosis from the anal margin, preoperative rectal capacity, and preoperative anal sensitivity were predictive of the severity of postoperative anal dysfunction.
2. Total and segmental transit time were measured using radiopaque markers in 34 patients after anterior resection, and were correlated with postoperative abdominal symptoms and anal function. Patients having frequent abdominal symptoms were found to have longer total and left-sided large bowel transit times. In patients having a large neorectal capacity after LAR,a longer transit time was associated with a poor anal function. The results of the marker study well correlated with those of scintigraghic analysis using ^<111>In-DTPA.Elongation of total and right-sided colonic transit time after operation was significant in 14 patients who underwent the study both preoperatively and postoperatively.
3. Simple defecography immediately after routine barium enema examination clarified that the anorectal angle was obtuse in patients having a poor anal function after LAR.
4. Scintigraphic defecography using ^<99m>Tc-DTPA was performed in 19 patients after large bowel resection. Evacuation efficacy was normal in patients having a straight colorectal or coloanal anastomosis, whereas evacuation took a longer time in patients having a reconstruction using a reservoir.
5. Prolonged ambulatory manometric study of descending and sigmoid colon after LAR revealed hypermotility of these colonic segment in patients having a poor anal function.
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