Operative treatment of ulcerative colitis: conventional proctectomy with Brooke ileostomy versus mucosal proctectomy with ileoanal anastomosis.
Fifty-four patients with ulcerative colitis were operated on during a 3-year period; 35 had conventional proctectomy and Brooke ileostomy, and 19 had mucosal proctectomy, performed from the abdominal side, leaving 1-2 cm of the distal anal mucosa, and a straight ileoanal anastomosis (IAA) without diverting ileostomy. There were no operative deaths. In the ileostomy group 19 (54%) of the patients had a total of 38 reoperations: 10 laparotomies and 28 revisions of a perineal sinus. Three (16%) of the IAA patients had a total of five reoperations: four laparotomies and one closure of a loop ileostomy. All IAA patients had perfect continence day and night and a median stool frequency of 7.5/24 h 1 year after the operation. Ileostomy patients had significantly longer time out of work, and more urinary, sexual, and social dysfunctions than the IAA patients. After 2-3 years' follow-up study, all differences in results are greatly in favour of the ileoanal procedure.
Emblem
R
R
Institute for Surgical Research, National Hospital, Oslo, Norway.
Larsen
S
S
Torvet
S H
SH
Bergan
A
A
D000328:Adult; D001003:Anal Canal / Q000601:surgery*; D000714:Anastomosis, Surgical / Q000379:methods; D003093:Colitis, Ulcerative / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007081:Ileostomy / Q000379:methods*; D007082:Ileum / Q000601:surgery*; D007413:Intestinal Mucosa / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications; D011446:Prospective Studies; D012007:Rectum / Q000601:surgery*; D012086:Reoperation