O'Connell P R, Stryker S J, Metcalf A M, Pemberton J H, Kelly K A
Department of Surgery, Mayo Medical School, Rochester, Minnesota.
Surg Gynecol Obstet. 1988 Jan;166(1):47-54.
This study was done to determine the effect of mucosal rectectomy and ileal pouch to anal anastomosis (IAA) on pressure and motility of the anal canal. Fifty patients, 22 +/- 2 months after operation (mean plus or minus standard error of the mean), and 30 healthy control volunteers were studied. Twenty-eight patients had excellent continence, while 22 had episodic minor incontinence. The maximum resting pressure in the anal canal was reduced in patients with episodic incontinence compared with continent patients and control volunteers. The increase in pressure with squeeze was slightly greater in continent than in incontinent patients. The frequency of the anal slow waves was less after IAA than in control volunteers and the amplitude of the waves was greater. The frequency and amplitude, however, were not related to continence or resting pressure. In conclusion, decreased anal canal resting and squeeze pressures after ileal pouch to anal anastomosis are associated with episodic minor incontinence, while altered motility patterns in the anal canal are not.
本研究旨在确定黏膜直肠切除术及回肠贮袋肛管吻合术（IAA）对肛管压力及动力的影响。研究了50例术后22±2个月（均值±均值标准误差）的患者以及30名健康对照志愿者。28例患者控便良好，22例有偶发性轻度失禁。与控便良好的患者及对照志愿者相比，偶发性失禁患者的肛管最大静息压力降低。控便良好的患者用力时压力升高幅度略大于失禁患者。IAA术后肛管慢波频率低于对照志愿者，波幅则更大。然而，频率和波幅与控便情况或静息压力无关。总之，回肠贮袋肛管吻合术后肛管静息和用力时压力降低与偶发性轻度失禁相关，而肛管动力模式改变则与之无关。
