Prospective randomized trial to compare the stapled double lumen pouch and the sutured quadruple pouch for restorative proctocolectomy.
Thirty-three consecutive patients having restorative proctocolectomy since April 1986 were randomly allocated to reconstruction using a stapled J pouch (n = 18) or a sutured W pouch (n = 15). There were no deaths, but one patient required pouch excision for ischaemia (J). One patient developed a leak from the pouch necessitating loop ileostomy (J) and one patient had a low pouch vaginal fistula successfully treated by a seton (W). There were no other major complications. Median (range) operative time was 200 min (165-290) for J pouch and 255 min (220-330) for the W pouch (P less than 0.05). In 24 patients followed up for more than 4 months after restoring intestinal continuity, median frequency of defaecation over 24 h was 4 (3-6) for the J pouch and 4 (3-6) for the W pouch. There was no incontinence, urgency or soiling. These results indicate that the quicker J pouch provides identical functional results to the larger W pouch in this series of patients.
Keighley
M R
MR
Department of Surgery, General Hospital, Birmingham, UK.
Yoshioka
K
K
Kmiot
W
W
D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical; D003082:Colectomy / Q000379:methods*; D003093:Colitis, Ulcerative / Q000601:surgery; D003424:Crohn Disease / Q000601:surgery; D003672:Defecation; D006801:Humans; D007082:Ileum / Q000601:surgery; D007902:Length of Stay; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D011379:Prognosis; D011446:Prospective Studies; D011897:Random Allocation; D012007:Rectum / Q000503:physiopathology / Q000601:surgery*