Système gastro-intestinal et digestif

Abstrait

Anal Canal Electrosensitivity Test on Child Patients after Total Colectomy, Mucosal Protectomy and Ileal J Pouch-Anal-Anastomosis

Tomita R

Objectives: To clarify the role of anal canal sensitivity in soiling (minor incontinence; the seepage of mucus and/or stool during nighttime and/or daytime) in child patients after ileal J pouch-anal-anastomosis (IPAA), the author studied the sensory function of the anal canal. Twelve patients one year after IPAA for ulcerative colitis were studied (8 males, 4 females; aged 10.5 to 14.5 years, average 13.0 years).

Setting: Nihon University Hospital at Itabashi/Department of Pediatric Surgery

Methods: Four patients showed soiling (group A) and 8 patients showed continence (group B). Group C serving as controls consisted of 12 children with normal defecation (9 males, 3 females; aged 6 to 15 years, average 11.7 years). The anal canal sensitivity thresholds (ACST) on the oral side of the dentate line (ODL) and the anal side of the dentate line (ADL) were measured by anal canal electrosensitivity test.

Results: No patients in group A could discriminate between flatus and feces, but all those in group B could discriminate between them. In terms of ACST at the ODL, sensitivity levels of groups A and B were significantly lower than that of group C (P=0.0249, P=0.0004, respectively). In terms of ACST at the ADL, significantly lower sensitivity was found in patients of group A than in groups B and C (P=0.0039, P=0.0021, respectively).

Conclusion: The anal transitional zone may not contribute to discrimination between flatus and feces and not influence soiling following IPAA. Soiling after IAPP may be caused by damage to the sensory nerves in the ADL