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Canadian Journal of Gastroenterology
Volume 4, Issue 7, Pages 428-431
IDB: Trends in Surgical Therapy

Pouch Surgery — The Importance of the Transitional Zone

IC Lavery, WB Tuckson, VW Fazio, JR Oakley, JM Church, and JW Milsom

The Cleveland Clinic Foundation, Department of Colorectal Surgery, Cleveland, Ohio, USA

Copyright © 1990 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Patients with preservation of the transitional zone of the anal canal have less leakage and less need to wear pads than patients who have had mucosectomy. There is a significant difference in mean maximum resting pressure between patients that have had anal transitional zone preservation and mucosectomy. With preservation of the anal transitional zone, a mean maximum resting pressure of 57.6±3.8 mmHg was obtained compared with 47.3±4 mmHg in the mucosectomy group. Preservation of the resting pressure is dependent on preservation of internal anal sphincter integrity. The integrity of the sphincter is injured during mucosectomy due to anal dilation. Other factors affecting continence and stool frequency, such as diet, antidiarrheal medications, stool consistency and compliance, when examined were found to be unrelated factors.