[Ileoanal anastomosis with a J reservoir. The evolution of the technic and the results].
Beginning 1982, our group has been performing the technique of ileal pouch-anal anastomosis, changing the procedure for achieving better functional results, less morbidity and making it easier. Fifty patients operated on for ulcerative colitis and "polyposis coli" were grouped as follows: Group I (28): proctocolectomy, mucosectomy, handsewn anastomosis and temporary ileostomy; Group II (13): proctocolectomy without mucosectomy, leaving a rectal stump up to just the level of the puborectalis, instrumental anastomosis and no-ileostomy; Group III (9): Same as Group II but with the implant of an endoluminal prosthesis to defunction the pouch. From our results it is concluded that, provided an adequate selection of patients is done, the best technique is the one performed in Group III due to its simplicity, no morbidity related to the ileostomy, no risk of fistula and probably better functional results than in Group II.
Departamento de Cirugía General y Digestivo, Hospital Ramón y Cajal, Madrid.
V
V
Angel
J M
JM
Devesa
R
R
Martínez
E
E
Vicente
J
J
Nuño
D011125:Adenomatous Polyposis Coli / Q000453:epidemiology / Q000601:surgery; D001003:Anal Canal / Q000601:surgery; D000704:Analysis of Variance; D000714:Anastomosis, Surgical / Q000379:methods / Q000706:statistics & numerical data; D003082:Colectomy; D003093:Colitis, Ulcerative / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D007081:Ileostomy; D007082:Ileum / Q000601:surgery; D007431:Intraoperative Complications / Q000453:epidemiology; D007902:Length of Stay / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology; D016737:Proctocolectomy, Restorative / Q000379:methods* / Q000706:statistics & numerical data