[Long-term results of total colectomy insuring restoration of continence].
The early postoperative and long term results of 4 acute (3 toxic megacolon, 1 life threatening bleeding from colon diverticulitis) and 32 elective (16 colitis ulcerosa, 10 familiar polyposis, 4 diffuse Crohn disease, 2 total colon diverticulosis) total colectomies and continence reconstruction has been discussed. In the acute cases the continence has been restored in two steps with Kock reservoir, or with immediate ileorectostomy. In the elective cases the continence was ensured with 16 ileoanal anostomies and pouch formation (4 "S" and 12 "J" pouch), 12 ileorectostomies and two Kock reservoir, the operation has been finished only in 2 cases, with definitive Brooke type ileostomy. The operative lethality was 4/1 and 32/1, the serious postoperative complication rate 4/2 and 32/5 respectively. The long term results of 11 pouch operations and 13 ileorectostomies are discussed. A whole continence were achieved on 11/9 and 13/12 patients respectively. The nocturnal soiling and daily defecation frequency was 75% and 25% higher and the whole rehabilitation time was twice so long after pouch operation then after ileorectostomies. 11/3 and 13/8 patients could return to his or her original occupation. The importance of operations planed and carried out according to the patients personal interest is emphasized. Some special complications and the results of their treatment are discussed.
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Veszprém Megyei Csolnoky Ferenc Kórház-Rendelöintézet Altalános Sebészeti Osztály, Veszprém.
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D003082:Colectomy / Q000379:methods*; D003093:Colitis, Ulcerative / Q000601:surgery; D003424:Crohn Disease / Q000601:surgery; D004241:Diverticulum, Colon; D005242:Fecal Incontinence / Q000517:prevention & control; D005260:Female; D006801:Humans; D007081:Ileostomy; D007417:Intestinal Polyps / Q000601:surgery; D008297:Male; D008875:Middle Aged
Kontinenciát biztosító rekonstrukcióval végzett totalcolectomiák hosszú távú eredményei.