title: Evolutive study of the functional results after restorative proctocolectomy for ulcerative colitis.
abstract: OBJECTIVE
  Evolutive study of the functional results after restorative proctocolectomy for ulcerative colitis.
  
  
  METHODS
  Prospective study in 24 patients with an ileoanal "J" pouch (n = 8: mucosectomy and hand-sewn anastomosis; n = 16: stapled anastomosis without mucosectomy). A clinical survey was carried out during two evolutive follow-ups of the functional pouch (medians: 14.5 and 39.0 months) as well as an anorectal manometry study during the preoperative period and in two follow-ups after the creation of the pouch (medians: 6.0 and 35.5 months).
  
  
  RESULTS
  The mean frequency of defecation per 24 hours and per night was significantly reduced in the first follow-up (5.5 [24 h]; p < 0.003 and 1.0 [per night]; p < 0.009) compared with the postoperative period (7.9 [24 h] and 1.4 [per night]), with no significant changes in the second follow-up (5.5 [24 h] and 0.9 [per night]). At the same time, it has been significantly lower in patients with stapled anastomosis in the different evolutive follow-ups. One patient (4.2%) had major fecal incontinence in the two evolutive follow-ups and 7 (29.2%) and 6 (25%) patients had minor incontinence in the first and second follow-up respectively. The mean maximum resting anal pressure in the first follow-up was significantly lower (p = 0.002) in patients with mucosectomy than the values observed in patients with stapled anastomosis (35.4 vs 68.0 mmHg). In the second follow-up increased significantly (p = 0.046) only in patients with mucosectomy (55.1 mmHg). Recto-anal inhibitory reflex was present in 2 (10%) and 9 (45%) patients in the first and second follow-up respectively.
  
  
  CONCLUSIONS
  The functional results improve significantly with the follow-up time, fundamentally during the first year of the functional pouch.
authors.affiliation: Servicio de Cirugía General, y Digestiva, Hospital de Sagunto y Clínico Universitario, Valencia.
authors.forename: J
authors.initials: J
authors.lastname: García Armengol
authors.forename: J
authors.initials: J
authors.lastname: Hinojosa
authors.forename: S
authors.initials: S
authors.lastname: Lledó
authors.forename: J V
authors.initials: JV
authors.lastname: Roig
authors.forename: E
authors.initials: E
authors.lastname: García-Granero
authors.forename: S A
authors.initials: SA
authors.lastname: García
authors.forename: R
authors.initials: R
authors.lastname: Alós
authors.forename: M
authors.initials: M
authors.lastname: Mínguez
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000503:physiopathology; D016009:Chi-Square Distribution; D003093:Colitis, Ulcerative / Q000503:physiopathology* / Q000601:surgery; D016001:Confidence Intervals; D003672:Defecation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008365:Manometry / Q000706:statistics & numerical data; D016737:Proctocolectomy, Restorative / Q000706:statistics & numerical data; D011446:Prospective Studies; D012007:Rectum / Q000503:physiopathology; D018709:Statistics, Nonparametric; D013997:Time Factors