Restorative proctocolectomy with a three-loop ileal reservoir for ulcerative colitis and familial adenomatous polyposis. Clinical results in 66 patients followed for up to 6 years.
The results of restorative proctocolectomy with a three-loop ileal reservoir were reviewed. Of 66 patients treated between 1976 and 1982, 52 had ulcerative colitis and 14 had familial adenomatous polyposis. The temporary ileostomy was closed between 2 and 78 months previously in 63 cases. Of these, three patients had had the reservoir removed and two were lost to follow-up. One other patient was subsequently found to have Crohn's disease. Function was assessed in 55 patients who had undergone closure of the ileostomy more than 8 weeks previously. Mean frequency of defecation was 3.7 per 24 hours (range 1-9.5) and 11 patients (20%) were taking antidiarrheal medication. Spontaneous defecation occurred in 22 patients (40%) while 29 (52.7%) had to use a catheter passed per anum. Four patients defecated spontaneously but sometimes used a catheter. Continence was normal in 36 (65.4%) and minor leakage once every 2 to 3 days occurred at night in 16 (29.1%). Three patients (5.4%) had some soiling during day and night. Troublesome perianal soreness (five patients, 9.1%) necessitated a defunctioning ileostomy in one. Fifty-four of the 55 patients assessed preferred their quality of life to that with an ileostomy.
D000328:Adult; D003082:Colectomy / Q000379:methods*; D003093:Colitis, Ulcerative / Q000601:surgery*; D003672:Defecation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007081:Ileostomy; D007082:Ileum / Q000601:surgery*; D007417:Intestinal Polyps / Q000235:genetics / Q000601:surgery*; D008297:Male; D008722:Methods; D009378:Neoplasms, Multiple Primary / Q000235:genetics / Q000601:surgery*; D011183:Postoperative Complications; D012007:Rectum / Q000601:surgery*