Construction of ileal reservoir with longitudinal ileal myotomy.

An attempt was made to construct an ileal reservoir in 15 colectomized dogs by making a longitudinal myotomy of 15 cm length. The volume of the myotomized ileal segment did not increase, even when accompanied by more than 50 per cent obstruction of the distal sigmoid colon for periods of follow-up to 4 months. Peristalsis was not altered by the longitudinal muscular incision on the antimesenteric side of the ileum. Although the operative technique for longitudinal ileal myotomy has the benefit of simplicity compared with construction of an ileal reservoir, the latter techniques, which have been used clinically on an extensive basis, are more likely to produce a consistent distension that is suitable for fecal storage. Although there were no leaks from the mucosa and no complications occurred in the 15 dogs evaluated, the dilatation of an isolated ileal segment was so minor that this technique appears to have little application in the treatment of patients undergoing the endorectal ileal pullthrough procedure.