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1990 Fiscal Year Final Research Report Summary

Studies Onpathophysiology After Total Colectomy, Mucosal Proctectomy and Ileoanal Anastoniosis.

Research Project

Project/Area Number 63480315
Research Category

Grant-in-Aid for General Scientific Research (B)

Allocation TypeSingle-year Grants
Research Field Digestive surgery
Research InstitutionHyogo Medical University

Principal Investigator

UTSUNOMIYA Joji  Hyogo College of Medicine, Professor, 医学部, 教授 (70013901)

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)
Project Period (FY) 1988 – 1990
Keywordstotal colectomy / ileoanal anastomosis / ulcerative colitis / adenomotous polyposis coli / anal function / metabolic changes / pouchitis / colonalization
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 … More 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

  • Research Products

    (18 results)

All Other

All Publications (18 results)

  • [Publications] M.Kusunoki,Y.Sakanove,Y.Shoji,K.Kosuhara,T.Yamamura,J.Utsunomiya: "Conversion of maltunctioning Jーpouch to kock'spouch" Acta.Chir.Scand. 156. 179-181 (1990)

    • Description
      「研究成果報告書概要(和文)」より
  • [Publications] Y.Sakanove,M.Kusunoki,T.Yamamura,J.Utsunomiya: "Crohn's disease in ileal Jーpouch" Dis&Rect. 33(6). 541 (1990)

    • Description
      「研究成果報告書概要(和文)」より
  • [Publications] T.Hatada,M.Kusunoki,T.Sakiyama,Y.Sakanove,T.Yamamura,R.Okutani,K.Kono,H.Ishida,J.Utsunomiya: "He odynamics in the prone jackknite position during surgery." Am.J.Surg. (1991)

    • Description
      「研究成果報告書概要(和文)」より
  • [Publications] Y.Sakanoue,M.Kusunoki,T.Hatada,T.Sakiyama,S.Fujita,T.Yamamura J.Utsum: "The Lipocortin of colon mucosa in ulcerative colitis." Horm.Meta,Res. 8(22). 453-454 (1990)

    • Description
      「研究成果報告書概要(和文)」より
  • [Publications] 宇都宮 譲二: "全結腸切除・直腸粘膜切除、回腸肛門吻合術後の排便機能の臨床的評価法としての排便抑制障害度" 日本消化器外科学会雑誌. 23(8). 2168-2173 (1991)

    • Description
      「研究成果報告書概要(和文)」より
  • [Publications] M.Kusunoki,Y.Shoji,H.Ikeuchi,K.Yamagata,T.Yamamura,J.Utsunomiya: "Usetulness of valproate sodium for treatment of incontinence after ileoanal anastomosis" Surgery. 107(3). 311-315 (1991)

    • Description
      「研究成果報告書概要(和文)」より
  • [Publications] Utsunomiya.J.and Yamamura.T.: "Total colectomy,mucosal proctectomy and ileoanal an astomosis practice and theory" Saunders, (1991)

    • Description
      「研究成果報告書概要(和文)」より
  • [Publications] J. Utsunomiya, T. Yamamura, M. Kusunoki, T. Iwama: "The current technique of ileoanal anastomosis" Dig Surg. 5. 207-214 (1988)

    • Description
      「研究成果報告書概要(欧文)」より
  • [Publications] J. Utsunomiya, T. Yamamura, Y. Fujimoto, Y. Shoju, M. Kusunoki, H. Aioi, K. Kusuhara, T. Kuroki, Y. Miki, M. Ohta: "On reconstructive method for proctocolectomy-Evaluation of ileoanal anastomosis-" Jap J Gastroent Surg. 21. 2487-2491 (1988)

    • Description
      「研究成果報告書概要(欧文)」より
  • [Publications] J. Utsunomiya, T. Yamamura: "Radikale Chirurgie bei Schwerer Colitis Ulcerosa" Der Chirurg. 60. 565-572 (1989)

    • Description
      「研究成果報告書概要(欧文)」より
  • [Publications] J. Utsunomiya, T. Yamamura, M. Kusunoki, H. Natori, Y. Fujimoto, Y. Shoji, T. Iwama: "J-pouch ; change of method over years" Verh Bd. 24. 249-251 (1989)

    • Description
      「研究成果報告書概要(欧文)」より
  • [Publications] J. Utsunomiya: "A method for clinical functional assessment after ileoanal anastomosis ーThe continence disturbance grade-" Jap J Gastroent Surg. 23. 2168-2173 (1990)

    • Description
      「研究成果報告書概要(欧文)」より
  • [Publications] M. Kusunoki, Y. Shoji, H. Ikeuchi, K. Yamagata, T. Yamamura, J. Utsunomiya: "Usefulness of valproate sodium for treatment of incontinence after ileoanal anastomosis" Surgery. 107. 311-315 (1990)

    • Description
      「研究成果報告書概要(欧文)」より
  • [Publications] Y. Fujimoto, T. Yamamura, M. Ohta, M. Kusunoki, Y. Shoji, H. Ikeuchi, J. Utsunomiya: "Pouchitis after ileal pouch-anal anastomosis" Jap J Gastroent Surg. 22. 969-972 (1989)

    • Description
      「研究成果報告書概要(欧文)」より
  • [Publications] Y. Sakanoue, M. Kusunoki, T. Hatada, T. Sakiyama, S. Fujita, T. Yamamura, J. Utsunomiya: "The lipocortin of colon mucosa in ulcerative colitis" Horm Meta Res. 22. 453-454 (1990)

    • Description
      「研究成果報告書概要(欧文)」より
  • [Publications] M. Kusunoki, T. Tanaka, Y. Sakanoue, T. Yamamura, J. Utsunomiya: "Salmonella infection after ileoanal anastomosis" Lancet ; July. 8. 113 (1989)

    • Description
      「研究成果報告書概要(欧文)」より
  • [Publications] M. Kusunoki, Y. Sakanoue, Y. Shoji, K. Kusuhara, T. Yamamura, J. Utsunomiya: "Conversion of malfunctioning J-pouch to Kock's pouch" Acta Chin Scand. 156. 179-181 (1990)

    • Description
      「研究成果報告書概要(欧文)」より
  • [Publications] T. Hatada, M. Kusunoki, T. Sakiyama, Y. Sakanoue, T. Yamamura, R. Okutani, K. Kono, H. Ishida, J. Utsunomiya: "Hemodynamics in the prone jackknife position during surgery" Am J Surg. (1991)

    • Description
      「研究成果報告書概要(欧文)」より

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Published: 1993-08-12  

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