Experience of restorative proctocolectomy with ileal reservoir.
The experience gained with restorative proctocolectomy and ileal reservoir in 60 patients is presented. Fifty-two patients had W reservoirs and the operative technique of the procedure is described in detail. Forty patients had a defunctioning ileostomy and 20 had a single stage procedure. There was no perioperative mortality. The main complications were sepsis (28 per cent), intestinal obstruction (18 per cent) and reservoir ileitis (20 per cent). There was a significant improvement in sepsis rate (from 20 to 4 per cent) and hospital stay (from 31.8 to 15.6 days) with increased experience. The functional results of 48 patients with W reservoirs was assessed. The mean number of evacuations per 24 h (+/- s.d.) was 3.8 +/- 0.2. Sixty-five per cent of patients did not evacuate at all, or rarely, at night and none evacuated more than once at night. Forty-four per cent of patients took antidiarrhoeal agents. Continence was normal in 50 per cent of patients. Minor leakage occurred in 46 per cent of cases, frequent leakage in 4 per cent and incontinence in none. Sexual function in 29 men was normal. Ninety-four per cent of patients considered the results of their operation to be good or excellent.
Everett
W G
WG
Addenbrooke's Hospital, Cambridge, UK.
D011125:Adenomatous Polyposis Coli / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D003082:Colectomy; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery*; D015212:Inflammatory Bowel Diseases / Q000601:surgery; D008297:Male; D008722:Methods; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012007:Rectum / Q000601:surgery*