Abstracts
1999 Digestive Disease Week

# 2088 PHYSIOLOGIC AND CLINICAL OUTCOME AFTER PROCTOCOLECTOMY AND JEJUNAL POUCH-ANAL CANAL ANASTOMOSIS
Fabio Teixeira, Miguel Pera, Marina Hinojosa-Kurtzberg, Mayo Clin Scottsdale, Scottsdale, AZ; Russell B. Hanson, Mayo Clin, Scottsdale, AZ; Keith A. Kelly, Mayo Clin Scottsdale, Scottsdale, AZ

Background: Our hypothesis was that a jejunal pouch transposed to the pelvis and interposed between the terminal ileum and the anal canal after proctocolectomy would slow small bowel transit, delay defecation,and decrease the number of postprandial stools compared to a conventional ileal pouch-anal canal anastomosis (IP). Methods: Ten dogs underwent proctocolectomy; 5 had jejunal pouch-anal canal anastomosis (JP) and 5 IP. All had electrodes implanted on the bowel and the pouch. Results: Both groups recovered well and regained their initial body weight by 12 weeks after operation. The mean frequency±SEM of proximal ileal pacesetter potentials (PP) was less in the JP dogs(12.6±0.7 cycles/min) than in the IP dogs(14.7±0.3 cpm, p=0.01), but the PP frequency in the two types of pouches was similar (JP=13.1±0.3 cpm, IP=13.4±0.2 cpm, p>0.05). JP dogs, however, had more action potentials (AP) in their pouches (JP=81±5.2 % PP had AP; IP=62±3.2 %, p<0.05). Gastric emptying of 60 ml 99m Tc-tagged egg white measured scintigraphically was similar in the two groups (JP T1/2=55±5.7 min,IP T1/2=56±12.3 min, p>0.05), but the time between eating and the first stool was longer in the JP dogs (263min±20min) than in the IP dogs (115±12min, p=0.001). In addition, JP dogs passed only 1.8±0.1 stools in the first 6 hr after eating, whereas IP dogs passed 3.6±0.4 stools (p=0.02). Conclusion: JP decreased the frequency of ileal PPs, slowed transit through the small intestine and pouch, and decreased the number of postprandial stools compared to IP. While more difficult to construct, JP may have physiologic and clinical advantages over IP in subjects who require proctocolectomy for ulcerative colitis and other diseases. Support: Mayo Foundation and CAPES of Brazil.

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