Pouch Surgery — The Importance of the Transitional Zone

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