title: Long-term results of the ileoanal pouch procedure.
abstract: Many surgeons consider the ileoanal pouch procedure to be the procedure of choice for patients who require surgery for ulcerative colitis and familial adenomatous polyposis. To determine long-term results, 460 patients (mean +/- SD age, 31 +/- 9 years) who underwent the ileoanal pouch procedure from 1980 through 1991 were prospectively observed by computerized registry. The leading indication for operation was ulcerative colitis (n = 382; 83%). A J-shaped reservoir was created in 434 patients (94%). More than 5 years after ileostomy closure, the mean number of bowel movements was 5.8 +/- 2.2, and 13% of patients had leakage. Most patients (94%) were satisfied with their results. Sixteen patients (3.5%) required recreation of a permanent stoma for pouch failure. Complications (major and minor) occurred in 266 patients (58%) and included obstruction (n = 94; 20%), pouch fistula (n = 26; 6%), anastomotic stricture (n = 40; 9%), anastomosis separation (n = 14; 3%), and pouchitis (n = 83; 18%). Modifications in technique and increased operative experience have significantly decreased the incidence of obstruction (P = .05) and pouch-related complications (P = .004). Despite complications, long-term results are acceptable, and patient satisfaction remains high.
authors: Department of Colon-Rectal Surgery, Lahey Clinic, Burlington, Mass.
authors: P W
authors: PW
authors: Marcello
authors: P L
authors: PL
authors: Roberts
authors: D J
authors: DJ
authors: Schoetz
authors: J A
authors: JA
authors: Coller
authors: J J
authors: JJ
authors: Murray
authors: M C
authors: MC
authors: Veidenheimer
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical / Q000009:adverse effects; D001424:Bacterial Infections / Q000209:etiology; D003082:Colectomy / Q000379:methods; D003093:Colitis, Ulcerative / Q000601:surgery; D003672:Defecation; D005242:Fecal Incontinence / Q000503:physiopathology; D005260:Female; D005414:Flatulence / Q000503:physiopathology; D005500:Follow-Up Studies; D006801:Humans; D007081:Ileostomy / Q000379:methods; D007249:Inflammation; D007415:Intestinal Obstruction / Q000209:etiology; D008297:Male; D017060:Patient Satisfaction; D016737:Proctocolectomy, Restorative / Q000009:adverse effects / Q000379:methods / Q000523:psychology; D011446:Prospective Studies; D014555:Urination Disorders / Q000503:physiopathology