Comparative study between ileo colic pedicle versus superior mesenteric pedicle division for mesenteric lengthening

ABSTRACT

Lengthening of the mesentery by vascular division may be necessary to perform an ileal pouch anal anastomosis without tension. Our objective is to compare the increase in mesentery length after division of ileo colic pedicle [ICP] and the superior mesenteric pedicle [SMP]. Was to compare the increase in length of the mesentery after division of the [ICP] and after division of the [SMP]. Total colectomy was performed in [14] patients. Which were then randomly divided into two groups. Pouch anal anastomosis was performed with division of the [ICP] in one group of seven patients and with division of the [SMP] in the other. The ileum was measured and the increase in length was recorded and compared statistically. The mean [s.d.] increase in length was 2.9 [0.8] cm. after [ICP] division and 6.5 [1.1] cm after [SMP] division [P<0.001]. The distance between the end of the ileum and the point giving the greatest length was 27.5 [4] cm in the [ICP] group and 46.8 [4.2] cm in [SMP] group [P<0.001]. The increase in mesenteric length was greater after [SMP] division than after [ICP] division, but if pouch-anal anastomosis is performed a short segment of small bowel must be removed