[Surgical treatment of ulcerative proctocolitis with total colectomy, resection of rectal mucosa and continent reconstruction with a ileoanal pouch anastomosis].
Between 1984 and 1988, 10 patients with ulcerative colitis underwent surgery involving total colectomy and ileoanal reconstruction with a J-pouch. In 8 of the 10 we selected the three-stage surgical procedure: 1. total colectomy, 2. proctomucosectomy, ileoanal pouch anastomosis and double path protective ileostomy, 3. ileostomy closure. In 2 patients colectomy and pouch-anal anastomosis were performed at the same time. In 3 of 10 patients postoperative complications occurred (1 pelvic abscess, 1 abdominal abscess, 1 ileus) after total colectomy. Complications after pouch-anal anastomosis occurred in 2 of 10 patients (1 abscess formation lateral to pouch, 1 entero-vaginal fistula). Follow-up in all 6 patients in whom ileostomy closure had already been possible showed that an average of 16 months (2-44 months) after restoration of continuity 5 (of 6) patients were fully continent for stool and 1 woman patient was slightly incontinent for thin stool. With an average of 4.2 stool evacuations during the day and 1 defecation at night, all 6 patients expressed a high degree of satisfaction with the operative result.
Oertli
D
D
Chirurgische Abteilung, St. Claraspital Basel.
Schuppisser
J P
JP
Gemsenjäger
E
E
Tondelli
P
P
D000293:Adolescent; D000328:Adult; D001003:Anal Canal / Q000601:surgery; D000714:Anastomosis, Surgical / Q000379:methods*; D003082:Colectomy; D003093:Colitis, Ulcerative / Q000601:surgery*; D006801:Humans; D007081:Ileostomy; D007082:Ileum / Q000601:surgery; D007413:Intestinal Mucosa / Q000601:surgery; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012007:Rectum / Q000601:surgery*
Chirurgische Behandlung der Proctocolitis ulcerosa durch totale Kolektomie, Proktomukosektomie und kontinente Rekonstruktion mit einer ileoanalen Pouch-Anastomose.