FUNCTIONAL DETERMINANTS AFTER RESTORATIVE PROCTOCOLECTOMY AND ILEAL POUCH-ANAL ANASTOMOSIS

A prospective study was undertaken in 17 patients undergoing restorati ve proctocolectomy for ulcerative colitis (13 patients) or familial ad enomatous polyposis (4 patients) to determine relationship between pre - and postoperative anal sphincter function, pouch characteristics and functional results. Postoperatively all manometric parameters were si gnificantly reduced and remained so permanently. Only squeeze pressure rose to normal values again. The most important factor for a favourab le functional outcome was pouch volume. A capacious reservoir was asso ciated with a low stool frequency, low risk of incontinence and genera l success of the operation, as assessed subjectively. Perianal sorenes s with considerable skin problems occurred frequently when resting and squeeze pressures were markedly reduced postoperatively.