Adaptation and effects of ileal reservoir on ileo-proctostomy following total colectomy in dogs.
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We examined postoperative adaptation and effects of J-pouch reservoir on ileo-proctos-tomy following total colectomy in dogs. End to end (E-E; n=5) or J-pouch (J-P; n=5) anastomosis was performed after resection of tatal colon and the rectum 3 cm above the peritoneal reflexion. Gastrointestinal motility with strain gauge force transducers (SG) and transit time with barium meal under the fluoroscopy were recorded 6 months after total colectomy. Then, histological changes of seven specimens from totally resected ileum in J-P and E-E vs control (normal ileum; n=5) were measured with hematoxylin-eosin and PYY immunohistochemical stains.<BR>Propagation rate of interdigestive migrating complex (IMC) from jejunum to ileum was significantly lower in J-P (64.8±13.2%) than in E-E (98.6±1.2%) (p<0.001). Oro-neor-ectal transit time (ONTT) in E-E (138±10min) was shorter (p<0.05), but ONTT in J-P (189±26min) was significantly longer (p<0.01) than oro-caecal transit time (OCTT) in preoperative control (165±19min; n=10). There was no difference about length of villi among control, E-E and J-P, but length of crypts in J-P (0.59±0.08mm) was longer than that in E-E (0.27±0.02mm) and normal ileum (034±0.07mm) (p<0.01). PYY positive cells in J-P were more than in E-E and control at any site of ileum and total number of PYY postitve cells in J-P (168±18) significantly increased than that in E-E (111±16) and control (103±14) (p<0.05).<BR>Thus, increase of PYY positive cells in J-P inhibits gastrointestinal motility and transit. Delayed transit time and crypts elongation were intestinal adaptation that assists the absorption of luminal contents. Therefore, it suggested that J-pouch reservoir had advantage to ileo-proctostomy following total colectomy in dogs.
- 日本平滑筋学会の論文
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