Dis Colon Rectum  1990 May;33(5):414-8 

Improvement of anal sensation with preservation of the anal transition zone

after ileoanal anastomosis for ulcerative colitis.

Miller R, Bartolo DC, Orrom WJ, Mortensen NJ, Roe AM, Cervero F.

Department of Surgery, Bristol Royal Infirmary, United Kingdom.

One of the most important considerations in restorative proctocolectomy for

ulcerative colitis is postoperative continence. Preservation of the anal

transition zone has been associated with improved results after this procedure

in the pediatric age group. This study was carried out to determine the effect

of preservation of the amal transition zone in adult patients undergoing

restorative proctocolectomy, comparing a group of patients with the anal

transition zone preserved with a group of patients with the anal transition zone

removed. Physiologic testing demonstrated improved sensation in those patients

with a preserved anal transition zone. Functional results were not significantly

improved, although there was a trend toward improved continence and

discrimination in those with the anal transition zone preserved. Although the

results are early and are not conclusive from the clinical standpoint, they are

certainly encouraging and may justify continued use of this technique.