[(Procto)colectomy with permanent ileostomy versus restorative proctocolectomy in ulcerative colitis; the past as background for the present].
In the University Hospital of Utrecht, in order to assess the value of 'restorative' proctocolectomy, the early and late complications after 'classical' (procto)colectomy with establishment of a permanent ileal stoma were evaluated retrospectively over the period 1969-1988. The inclusion criteria were: having undergone a (procto)colectomy with establishment of an ileal stoma because of pathologico-anatomically confirmed ulcerative colitis, with follow-up in the clinic mentioned. Data on the preoperative period, on the operation and on the early and late complications were collected of 101 patients. Immediately postoperative complications were encountered in 50% of the patients. Mortality was 2% in the group as a whole and 5% after emergency surgery. Late complications occurred in 62% of the patients, and in 45% of the patients they necessitated one or several reoperations. Sources of late complications included: the rectal stump left in situ, the perineal wound area, the stoma and the formation of abdominal adhesions. Classical (procto)colectomy with establishment of a permanent ileal stoma entails a large proportion of early and late postoperative complications. It is asserted that the complications at present observed after restorative proctocolectomy must not prompt a return to classical proctocolectomy as the standard surgical treatment of ulcerative colitis.
Broeders
I A
IA
Afd. Chirurgie, Academisch Ziekenhuis, Utrecht.
Poen
H
H
Ottow
R T
RT
van Vroonhoven
T J
TJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000601:surgery; D003082:Colectomy / Q000379:methods*; D003093:Colitis, Ulcerative / Q000601:surgery*; D005260:Female; D006801:Humans; D007081:Ileostomy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012007:Rectum / Q000601:surgery; D012189:Retrospective Studies
(Procto)colectomie met permanent ileostoma versus restauratieve proctocolectomie, bij colitis ulcerosa; het verleden als achtergrond voor het heden.