What Happens to the Rectal Muscular Cuff? An Experimental Study in Dogs

Abstract

The anatomy and histology of the rectal muscular cuff was studied in 15 dogs with an ileal pouch-anal anastomosis. Eight channel, three-dimensional anal manometry showed normal maximal squeeze pressure (128 +/- 20 mm Hg) compared to a control group (135 +/- 4 mm Hg). The rectal muscular cuff showed complete absence of the cuff in three cases. In 12 dogs, the rectal cuff was retracted to a length of less than 1 cm, the muscle fibers were degenerated and fibrotic. The results in the canine model and the clinical results of patients with an ileal pouch-anal anastomosis with a cuff demonstrated that a rectal muscular cuff is not essential to maintain continence after ileal pouch-anal anastomosis.