Physiological and pharmacological properties of a modified Brooke ileostomy: justification for retaining the most distal ileum

Autor: Martha Quinn, Mary Speirs, Vlad Shumeyko, Angus Macdonald, Praveen Sharma, Isabell Robertson
Rok vydání: 2013
Předmět:
Zdroj: International Journal of Colorectal Disease. 28:973-975
ISSN: 1432-1262
0179-1958
DOI: 10.1007/s00384-012-1635-z
Popis: The traditional Brooke ileostomy removed the last 8–15 cm of the ileum due to concern of occurrence of terminal ileal Crohn’s disease, vide infra the ileocolic sphincter was removed. Retaining all the terminal ileum has the potential of retaining the ileocolic sphincter. Our aim was to investigate whether a high-pressure zone existed within the last few centimetres of the ileum and its response to pharmacological stimuli. A balloon manometry catheter was introduced into the stoma of 16 patients who had formation of an end ileostomy (ileocolic sphincter retained, ICS). Recordings were made at 1 cm intervals from the meatus in order to identify the maximum intra-luminal resting and intra-abdominal pressure. At the point of maximum resting pressure, the response to phenylephrine (10 % gel) and glyceryl trinitrate (GTN) (0.2 % paste) was recorded. Results were recorded using an Ohmeda Oestiva 5 manometry system (in millimeter of mercury) and data were analysed using ANOVA. Results were compared with 13 historical controls (ileocolic sphincter removed). There was no significant difference in resting intra-abdominal pressure between the two groups (historical controls 8.5 ± 3.0 mmHg; ICS 9.0 ± 3.2 mmHg), p = NS. The maximum resting intra-luminal pressure in ICS patients exceeded historical controls 16 ± 2.9 vs 10.0 ± 2.5 mmHg, p
Databáze: OpenAIRE
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