[Direct ileum pouch-anal anastomosis in ulcerative colitis. Technique and complications].
Fourty-nine patients (21 female, 28 male) with ulcerative colitis underwent formation of an J-ileal pouch and construction of a direct stapled pouch-anal anastomosis (IPAA) without rectal cuff. 16 patients had previously undergone surgical interventions. Overall after IPAA 7 patients (14%) experienced 11 major complications. Gastrointestinal complications included hemorrhage in 1 patient, pelvic sepsis and ileus in 3 patients, respectively. Pancreatitis and urinary infection occurred in 2 patients, sexual dysfunction in 3 patients. After closure of the ileostomy 3 patients developed late pouch-vaginal or pouch-vesical fistulas, leading to excision of the pouch. During the long-term follow-up small bowel obstruction developed in 3 patients, pouchitis in another 6 patients. After 3 months 84% of our patients were continent during daytime, 67% during nighttime. 24 months postoperatively these data concerning continence increased to 92% and 83%, respectively. We conclude that direct IPAA is a reliable procedure achieving its purpose in 96%.
Braun
J
J
Chirurgische Klinik, Medizinischen Fakultät, RWTH Aachen.
Schumpelick
V
V
D011125:Adenomatous Polyposis Coli / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000601:surgery*; D000714:Anastomosis, Surgical / Q000379:methods*; D003082:Colectomy / Q000379:methods*; D003093:Colitis, Ulcerative / Q000601:surgery*; D005242:Fecal Incontinence / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007081:Ileostomy / Q000379:methods; D007082:Ileum / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery*; D011446:Prospective Studies; D013528:Surgical Staplers
Die direkte ileumpouchanale Anastomose bei der Colitis ulcerosa. Technik und Komplikationen.