Stricture of ileo-anal J pouch anastomosis increased the intensity of pouchitis in an experimental rat model.
Summary of "Stricture of ileo-anal J pouch anastomosis increased the intensity of pouchitis in an experimental rat model."
Background: Pouchitis appears to be the most common complication after restorative proctocolectomy. Material/Methods: In experimental models we investigated the correlation between the width of anastomosis and the frequency of pouchitis. Twenty-three Wistar rats underwent restorative proctocolectomy under pentobarbital anesthesia. Normal width anastomosis was performed in 11 animals (Group I). In the remaining 12 animals (Group II) the diameter of anastomosis was reduced by 50%. All animals were sacrificed and the pouch mucosa was histologically (Moskowitz score) and immunohistochemically (IL-1, IL-6, IL-10, IL-12 expression) examined. Results: Morphological assessment of pouchitis symptoms based on Moskowitz scale revealed considerably more severe inflammation (p=0.0079) in the animals from Group II than in the rats from Group I. The expressions of investigated cytokines, assessed qualitatively in histopathological examination, were higher in rats with narrow anastomosis in comparison with animals with normal anastomosis. Conclusions: The stricture of anastomosis increases the intensity of pouchitis and stimulates the production of interleukins. It seems that anastomotic stricture plays an important role in the development of pouchitis.
Department of General Surgery, Gastroenterological Oncological Surgery and Plastic Surgery, K. Marcinkowski University of Medical Sciences, Poznan, Poland.
This article was published in the following journal.
Name: Medical science monitor : international medical journal of experimental and clinical research
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Medical and Biotech [MESH] Definitions
Acute INFLAMMATION in the INTESTINAL MUCOSA of the continent ileal reservoir (or pouch) in patients who have undergone ILEOSTOMY and restorative proctocolectomy (PROCTOCOLECTOMY, RESTORATIVE).
A Y-shaped surgical anastomosis of any part of the digestive system which includes the small intestine as the eventual drainage site.
A vessel that directly interconnects an artery and a vein, and that acts as a shunt to bypass the capillary bed. Not to be confused with surgical anastomosis, nor with arteriovenous fistula.
Surgical procedure in which the STOMACH is transected high on the body. The resulting small proximal gastric pouch is joined to any parts of the SMALL INTESTINE by an end-to-side SURGICAL ANASTOMOSIS, depending on the amounts of intestinal surface being bypasses. This procedure is used frequently in the treatment of MORBID OBESITY by limiting the size of functional STOMACH, food intake, and food absorption.
Tumors or cancer of the anal gland.