O'Connell P R, Pemberton J H, Brown M L, Kelly K A
Am J Surg. 1987 Feb;153(2):157-64. doi: 10.1016/0002-9610(87)90807-5.
The aim of our study was to determine whether ileal pouch motility and evacuability and the 24 hour fecal output influence stool frequency after ileal pouch-anal anastomosis. In 23 patients, at a mean of 24 months postoperatively (range 22 to 26 months), ileal pouch motility was measured using an intraluminal bag and pressure-sensitive catheters. The pattern and efficiency of ileal pouch emptying was determined scintigraphically. A 24 hour stool collection was made and the stool output and stool frequency recorded. The volume of ileal pouch distention at which large amplitude propulsive waves appeared (the threshold volume) correlated closely with stool frequency. The larger the threshold volume, the fewer the stools per 24 hours (correlation coefficient -0.70; p less than 0.01). Also, the greater the 24 hour stool output, the greater the stool frequency (correlation coefficient 0.79, p less than 0.001). In contrast, the efficiency of ileal pouch evacuation was less strongly related to stool frequency (correlation coefficient -0.41, p = 0.05). We conclude that ileal pouch motility and stool output are major determinants of stool frequency after ileal pouch-anal anastomosis. Inefficient pouch emptying is less commonly associated with frequent bowel movements.
我们研究的目的是确定回肠贮袋的运动性、排空能力以及24小时粪便排出量是否会影响回肠贮袋肛管吻合术后的排便频率。对23例患者在术后平均24个月（范围22至26个月）时，使用腔内袋和压敏导管测量回肠贮袋的运动性。通过闪烁扫描法确定回肠贮袋排空的模式和效率。进行24小时粪便收集，并记录粪便排出量和排便频率。出现大幅度推进波时的回肠贮袋扩张体积（阈值体积）与排便频率密切相关。阈值体积越大，每24小时的排便次数越少（相关系数-0.70；p<0.01）。此外，24小时粪便排出量越大，排便频率越高（相关系数0.79，p<0.001）。相比之下，回肠贮袋排空效率与排便频率的相关性较弱（相关系数-0.41，p = 0.05）。我们得出结论，回肠贮袋的运动性和粪便排出量是回肠贮袋肛管吻合术后排便频率的主要决定因素。贮袋排空效率低下与频繁排便的关联较少。
