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Biomedical subjects

M Pescatori

Publications and source records attributed to M Pescatori.

At least 109 records · Page 6Linked to original sources
PubMed1984

Transmucosal myotomy of the small bowel after ileoanal anastomosis.

Posterior transmucosal myotomy of the small bowel distal to the pelvic pouch was carried out in two patients who underwent restorative proctocolectomy for ulcerative colitis. Painful spasms of the efferent limb and outlet obstruction of the reservoir were the main indications for surgery. Laparotomy was unnecessary, as the operation could be performed either through a transanal route or by means of a rigid sigmoidoscope. Both patients showed marked clinical improvement after myotomy; therefore, it may be considered an effective and safe procedure in the treatment of functional and mechanical disorders of the small intestine above an ileoanal anastomosis.

Adult↗
PubMed1984

Restorative proctocolectomy with a three-loop ileal reservoir for ulcerative colitis and familial adenomatous polyposis. Clinical results in 66 patients followed for up to 6 years.

The results of restorative proctocolectomy with a three-loop ileal reservoir were reviewed. Of 66 patients treated between 1976 and 1982, 52 had ulcerative colitis and 14 had familial adenomatous polyposis. The temporary ileostomy was closed between 2 and 78 months previously in 63 cases. Of these, three patients had had the reservoir removed and two were lost to follow-up. One other patient was subsequently found to have Crohn's disease. Function was assessed in 55 patients who had undergone closure of the ileostomy more than 8 weeks previously. Mean frequency of defecation was 3.7 per 24 hours (range 1-9.5) and 11 patients (20%) were taking antidiarrheal medication. Spontaneous defecation occurred in 22 patients (40%) while 29 (52.7%) had to use a catheter passed per anum. Four patients defecated spontaneously but sometimes used a catheter. Continence was normal in 36 (65.4%) and minor leakage once every 2 to 3 days occurred at night in 16 (29.1%). Three patients (5.4%) had some soiling during day and night. Troublesome perianal soreness (five patients, 9.1%) necessitated a defunctioning ileostomy in one. Fifty-four of the 55 patients assessed preferred their quality of life to that with an ileostomy.

Adult↗
PubMed1984

The sphincteric and sensory components of preserved continence after ileoanal reservoir.

Sphincteric and sensory components of anal continence were investigated before and after restorative proctocolectomy and three loop ileal reservoir. Bowel habit, appearance of small intestinal mucosa, resting tone, squeeze pressure, anal canal length, pouch capacity and ileal sensation were investigated in 50 patients. The physiologic, endoscopic and histologic patterns were related to the occurrence of functional disturbances. The pressures in the anal canal as measured by manometry were found to be within the range of normality. The length of the sphincter was 3.4 +/- 0.6 centimeters; the maximal capacity of the reservoir was 450 +/- 204 milliliters of air. An ileorectoanal inhibitory reflex was recorded postoperatively in 52 per cent of the patients and normal postoperative continence was observed in 86 per cent of the patients, with no instances of gross incontinence. According to the results of the present study, the anatomic rearrangement that occurs after this surgical procedure preserved a satisfactory continence due to the integrity of the anal sphincters; minor leakage rarely occurred and was mainly related to a long inflamed distal portion of the ileum requiring self catheterization after operations for colitis. The best results were obtained in patients with polyposis who neither had staged procedures nor preoperative steroids.

Adolescent↗
PubMed1983

Evacuation pouchography in the evaluation of ileoanal reservoir function.

Thirty four patients with restorative proctocolectomy and ileoanal pelvic reservoirs were studied by "evacuation pouchography" to determine why only some patients could evacuate spontaneously. The 50 per cent who were able had a significantly shorter distal segment (P less than 0.02) of mean length (8 +/- 3 cm) that filled on straining, compared with those who had to use a catheter to empty the pouch, in whom the distal segment was longer (mean 11 +/- 4 cm) and often failed to fill on straining. The longer the distal segment, the more likely it was to be angulated, causing difficulty in passage of the catheter with possible ulceration and stenosis from minor trauma. Stricturing in the distal segment was associated with minor nocturnal leakage. A short distal segment is recommended to allow spontaneous evacuation and avoid the risks of repeated catheterization.

Adolescent↗
PubMed1983

Technique to facilitate low colorectal anastomosis.

A technique for elevating the rectal cuff and simplifying the construction of a low anastomosis is described. The proximal part of the stump is split into two longitudinal flaps and then easily pulled upward during the insertion of the sutures. Stitches are tied and step by step transverse division of the rectum performed.

Colon↗
PubMed1983

Peristaltic transport of a solid bolus.

An analysis of the peristaltic propulsion of a solid spherical bolus enclosed in a contractile membrane is presented. The model is based on in vitro preparations of intestinal segments, and utilizes a simplified representation of the mechanical properties of the muscular coats of the wall. The sequence of deformed configurations of the membrane and the displacement of the bolus are obtained by numerical solution of the model equations. The analysis presented in this paper could be useful for other studies in biomechanics (e.g. uterine contraction and motion of red blood cells in narrow capillaries).

Gastrointestinal Motility↗
PubMed1983

Some parameters of descending inhibition during colonic propulsion.

Isolated segments of rabbit distal colon were stimulated by distension of intraluminal balloons, with the aim of investigating the electrophysiological pattern of descending inhibition (DI) during the peristaltic reflex. Incidence, duration, and latency of DI were studied by varying the parameters of stimulation. A linear correlation was found between stimulus duration and DI duration for stimuli up to 10 s long. DI duration increased with the distance of the recording site from the stimulus up to 3 cm. A more complex relation was found between balloon volume and DI duration. Propagation velocity decreased with the distance from the stimulus. The relation between ascending excitation and DI was also studied: ascending excitation could always be suppressed by DI. DI was examined after addition of anticholinergics, ganglionic blocking agents, and tetrodotoxin to the organ bath. The results show that DI parameters are partially related to the stimulus characteristics and that propagation of DI is neurally mediated through nonadrenergic inhibitory nerves.

Animals↗
PubMed1979

An analysis of the peristaltic reflex.

A mathematical model describing the dynamics of the peristaltic reflex in an isolated intestinal segment is presented. The model is referred to a preparation that makes it possible to record the relevant mechanical and electrical variables during the course of the reflex. A simplified representation is used for the structure and the operation of the intrinsic nervous plexus, but the interaction between mechanical and elctrical events appears quite clearly and some features of the experimental data are well predicted.

Biomechanical Phenomena↗
PubMed1979

Peristalsis in distal colon of the rabbit: an analysis of mechanical events.

The mechanical behavior of isolated segments of rabbit distal colon was studied by experimental and theoretical techniques. The isometric isovolumic preparation was adopted to obtain records of endoluminal pressure, force, and wall morphology during 59 spontaneous and 53 electrostimulated peristaltic contractions. On strips of longitudinal and circular muscle, excised from the same segments, the tension-velocity and tension-length relationships were also measured. To describe mechanical events occurring during propulsion, a mathematical model was developed that incorporates the measured characteristics of the muscle. In response to given waveforms for the activation of the two muscular coats, the solution of model equations provides the time courses of pressure, force, and wall morphology. A number of parameters measured in the experimental contractions (e.g., pressure and force peaks, time lag between the stimulus and the peaks, velocity of progression of the peristaltic wave) were compared with model outputs, and a similar pattern of response was found. Therefore the model made it possible to relate segment and strip experimental data and to investigate the temporal and quantitative relationship between the contraction of longitudinal and circular layer.

Animals↗