ArticleJournal of neurogastroenterology and motility2012
Physiological and functional evaluation of the transposed human pylorus as a distal sphincter.
Article in Journal of neurogastroenterology and motility, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 9 citations in OpenAlex.
- Complex Obstetric Perineal Injury Reconstruction Using Antropyloric Valve Transposition.Annals of coloproctology · 2020Article
- Neurovascular antropylorus perineal transposition using inferior rectal nerve anastomosis for total anorectal reconstruction: preliminary report in humans.Techniques in coloproctology · 2014Article
- Feasibility of neurovascular antropylorus perineal transposition with pudendal nerve anastomosis following anorectal excision: a cadaveric study for neoanal reconstruction.Annals of coloproctology · 2013Article
- Anatomical basis of antropyloric transposition for fecal incontinence in humans: the infrapyloric approach.Surgical and radiologic anatomy : SRA · 2013Article
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Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND/
aimsStudies evaluating the human pylorus as a sphincter are scanty and contradictory. Recently, we have shown technical feasibility of transposing the human pylorus for end-stage fecal incontinence. This unique cohort of patients provided us an opportunity to study the sphincter properties of the pylorus in its ectopic position.
methodsAntro-pylorus transposition on end sigmoid colostomies (n = 3) and in the perineum (n = 15) was performed for various indications. Antro-pylorus was assessed functionally (digital examination, high resolution spatiotemporal manometry, barium retention studies and colonoscopy) and by imaging (doppler ultrasound, MRI and CT angiography) in its ectopic position.
resultsThe median resting pressure of pylorus on colostomy was 30 mmHg (range 28-38). In benign group, median resting pressure in perineum was 12.5 mmHg (range 6-44) that increased to 21.5 mmHg (range 12-29) (P = 0.481) and 31 mmHg (range 16-77) (P = 0.034) on first and second follow-up, respectively. In malignant group, median post-operative pressures were 20 mmHg (range 14-36) and 21 mmHg (range 18-44) on first and second follow-up, respectively. A definite tone and gripping sensation were felt in all the patients on digital examination. On distal loopogram, performed through the diverting colostomies, barium was retained proximal to the neo-pyloric valve. Both perineal ultrasound and MRI showed viable transposed graft. CT angiography and color doppler studies confirmed vascular flow in the transposed position.
conclusionsThe human pyloric valve can function as a tonic sphincter when removed from the gastroduodenal continuity.
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