[Pathophysiological study of the ileum after total colectomy in combination with mucosal proctectomy and ileoanostomy--the alteration in water and electrolyte absorption by the ileum after ileoanostomy].

We have developed a new procedure, total colectomy in combination with mucosal proctectomy and ileoanostomy, to preserve anorectal function for the patients with adenomatosis coli and ulcerative colitis. Using dialysis method, we evaluated the alteration of the ability to absorb water and electrolytes at the ileum after ileoanostomy in 12 patients with adenomatosis coli and 4 patients with ulcerative colitis, and compared the result with fecal volume and content to investigate compensatory function of the small intestine after total colectomy. Volume of water absorbed at the ileum was 0.389 g in an average soon after the first stage operation but gradually increased after the intestinal continuity was restored following the second stage operation with the volume of 0.666 g after 1 year and 0.702 g after 2 years (1.8 fold increase). Fecal volume excreted was 852 g/day in an average after loop ileostomy (first stage operation) but decreased to 316 g/day in a year after the second stage operation with simultaneous change of fecal character from watery to solid. The decrease of fecal volume was inversely correlated with the increase of the volume of water absorbed at the ileum (p less than 0.001). The ability to absorb electrolytes increased after the second stage operation compared to that of after the first stage operation but subsequently minimal change was noted. And the absorption pattern was different from that of the large intestine.