[Total proctocolectomy with ileo-anal reservoir in "J". Experience at the Salvador Zubirán National Institute of Nutrition].
BACKGROUND
Total proctocolectomy with ileal pouch-anal anastomosis (TPCIAA) is the procedure of choice for patients with Ulcerative Colitis and Familial Adenomatous Polyposis. The frequency of presentation of both diseases is low in Mexico, therefore the experience with the surgical procedure is limited.


OBJECTIVE
To analyze the operative morbidity and mortality and long-term functional results in a series of patients operated upon with the TPCIAA in a referral center in Mexico.


METHODS
Retrospective analysis of 44 consecutive patients operated upon from 1987 through 1997. The operation included resection of the anal transitional zone, handsewn anastomosis of a "J" pouch, and diverting ileostomy in all cases. Operative morbidity and mortality, and long-term functional results and complications were determined.


RESULTS
Mean age was 33 +/- 15 years. There were 52% women and 48% men. Diagnoses were ulcerative colitis in 59% and familial polyposis in 36%. Global morbidity was 39%, and mortality 2%. With a mean follow-up of 24 months, mean number of bowel movements was 4, 10% of patients had diurnal spotting, 30% nocturnal spotting, and no patient had gross incontinence. Three patients presented pouchitis with adequate response to antibiotics. Two patients presented long-term pouch fistulas that did not require pouch excision.


CONCLUSIONS
The TPCIAA is a feasible operation with acceptable rates of morbidity and mortality and satisfactory functional results.
Takahashi
T
T
Departamento de Cirugía, Instituto Nacional de la Nutrición Salvador Zubirán.
Cárdenas
S
S
Arch-Ferrer
J
J
Remes-Troche
J M
JM
Ayala-Ramírez
M
M
García-Osogobio
S
S
Mass
W
W
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D016737:Proctocolectomy, Restorative / Q000009:adverse effects; D012189:Retrospective Studies