[Technique and results of ileoanal pouches in ulcerative colitis after colectomy and proctomucosectomy].
The continence preserving restorative proctocolectomy is the operation of choice for ulcerative colitis. Many technical aspects of the J-pouch procedure have been standardised. We prefer the hand-sewn pouch-anal anastomoses and construct a protective ileostomy in most patients. Latter allows to carefully assess the sphincter function postoperatively and--if necessary--to train the sphincter before restoring continence. The frequency of postoperative ileus is comparable to that after other major intraabdominal surgery. Septic pelvic complications occur in up to 10% of patients and determine the long-term prognosis of pouch function. Following pouch reconstruction, the stool frequency remains increased (4-6 per day) and continence may be partially impaired especially at night. These consequences are accepted by most patients. Because the ileoanal pouch procedure is a difficult and complicated operation, it should be performed by experienced surgeons only.
Runkel
N
N
Chirurgische Klinik I und Poliklinik, Universitätsklinikum Benjamin Franklin, Freie Universität Berlin.
Kroesen
A
A
Buhr
H J
HJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000503:physiopathology; D000714:Anastomosis, Surgical; D002648:Child; D003082:Colectomy; D005242:Fecal Incontinence / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007081:Ileostomy; D007413:Intestinal Mucosa / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology; D016737:Proctocolectomy, Restorative; D012007:Rectum / Q000503:physiopathology / Q000601:surgery*; D013536:Suture Techniques
Technik und Ergebnisse des ileoanalen Pouches bei Colitis ulcerosa nach Colektomie und Proktomukosektomie.