The healing of the anastomotic lines was acceptable (pathologically) in all. The mean volume expansion was 20.9% in Group A, 21.7% in Group B, and 118.2%
in Group C, with the latter being significantly higher than that of the other groups (P=0.03). Colon J-pouch and coloplasty after proctectomy in some situations have not been performable. This study evaluated the performance of ileal J-pouch interposition. Conclusion: This study showed that ileal J-pouch interposition might produce an acceptable reservoir function and that it seems Inhibitors,research,lifescience,medical feasible and safe in selected cases. Keywords: Rectum, Ileal pouch, Reconstruction Introduction The gold standard of low rectal cancer has been low anterior resection with total mesorectal excision. The neorectum is constructed with the remaining
left colon. However, almost all of the patients with straight coloanal anastomosis have tolerated some complications of defecation after low anterior resection such as urgency, Inhibitors,research,lifescience,medical frequency, soiling, anastomotic line stenosis because of the vascular tension of the sigmoid colon, and incontinence due Inhibitors,research,lifescience,medical to the low capacity of the neorectum.1,2 Some procedures have been described to resolve this low compliance, including side-to-end coloanal anastomosis, transverse coloplasty, and colonic J-pouch.3 Small colonic J-pouch has had an optimal function in that it can reduce difficult evacuation from 30% to 10% at long-term follow-up.4,5 Nevertheless, in some situations, similar to previous colonic resection, owing to diffuse diverticulosis, bulky sphincter, insufficient Inhibitors,research,lifescience,medical colon length, pregnancy, complex surgery and narrow pelvis, surgeons cannot reconstruct the reservoir with the colon.3 Accordingly, in this animal pilot study, we tried to construct the neorectum with the interposition of the ileal J-pouch between the anal canal and the remaining colon. We thereafter evaluated the efficacy of the ileal J-pooch as a neorectum in comparison to straight Inhibitors,research,lifescience,medical coloanal
anastomosis and transverse coloplasty. Materials and Methods Materials The present study was performed in the Animal House of Shiraz University of Medical Sciences (South of Iran) in August, September, and October 2011 and was approved by the Ethics Committee of Shiraz University of Medical Sciences for the use of laboratory Advanced Drug Delivery Reviews animals. In this study, 12 German shepherd dogs, weighing 23-27 kg, were selected and divided into three equal groups. Surgical Procedure All the dogs were anesthetized with 17 mg/kg of thiopental intravenously. After intubation, anesthesia was continued through a mixture of halothane and oxygen up to the end of the operation. Hydration of the samples was maintained by 1000 cc of D/S during the operation. Additionally, half of a pen-and-strep vial (3 PXD101 million units of penicillin plus 3 g of streptomycin) and a 1 g of Keflin were injected preoperatively. Then via a midline laparotomy incision, a clamp was placed 10 cm proximal to the anus.