The P-pouch: a New Ileal Reservoir Used in Restorative Proctocolectomy.
- Author:
Joobong LEE
1
;
Sungpil YUN
;
Nahmgun OH
Author Information
1. Department of Surgery, Pusan National University School of Medicine, Busan, Korea. colon@pusan.ac.kr
- Publication Type:Original Article
- Keywords:
Ileoanal anastomosis;
Restorative proctocolectomy;
P-pouch;
PYY
- MeSH:
Colloids;
Colonic Pouches*;
Fires;
Humans;
Ileostomy;
Ileum;
Meals;
Peptide YY;
Plasma;
Pouchitis;
Proctocolectomy, Restorative*;
Sulfur
- From:Journal of the Korean Society of Coloproctology
2006;22(6):363-370
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To evaluate the effectiveness of a P-pouch configuration with a reservoir and recycled segment in restorative proctocolectomy. METHODS: There were 11 patients who underwent the P-pouch procedure. They were compared with healthy eight-control subjects. The P-pouch configuration was constructed using one firing of a 10 cm GIA stapler to form a 12-cm reservoir. Following that, the distal ileum (15+/-0.5 cm) was anastomosed to the proximal portion of the pouch. Pouch function was studied 23.3+/-4.4 months after ileostomy closure. We measured the frequency and amount of stool. The postprandial plasma peptide YY (PYY) response and the scintigraphic studies using 99m-Tc sulfur colloid were used to study transit. RESULTS: In the patient group, daily stool frequency and volume were 5.2+/-0.3 and 423.5+/-23.7 g, respectively. Stool seepage and pouchitis occurred in 45.5 % and 9.1%. In contrast to other pouch procedures, the postprandial increment of plasma PYY was similar the P-pouch patients and healthy controls (P>0.05). The integrated increment of plasma PYY for 180 minutes following meals was also not decreased in 9-pouch patient group compared with the healthy controls (1,050.0+/-127.8 pmol/l vs. 1146.0+/-150.0 pmol/l, P>0.05). Small intestinal transit time for healthy controls and the patient group averaged 89+/-21 and 117+/-12 minutes (P>0.05). The capacity of the ileal pouch was 372+/-22 ml, and the efficiency of ileal reservoir evacuation was 76 %. CONCLUSIONS: The P-pouch is a new and improved simple modification of the well-established J-pouch procedure, constructed using a single firing of a GIA stapler.
