Clinical results after restorative proctocolectomy without diverting ileostomy for ulcerative colitis.
OBJECTIVE
This study evaluated the postoperative complications and clinical results of restorative proctocolectomy without diverting ileostomy for ulcerative colitis.


METHODS
One hundred selected patients had a hand-sewn ileal J-pouch anal anastomosis with mucosectomy using an ultrasonically activated scalpel.


RESULTS
Three patients with pouch-related complications who needed diverting ileostomy. Five patients showed intestinal obstruction; two of the five needed relaparotomy and division of adhesions. The median number of bowel movements per 24 h was 6.5 (2-13) at 3 months and 5 (3-10) at 12 months. The corresponding nightly frequencies were 0 (0-5) at 3 months and 0 (0-3) at 12 months. After 3 months 82% of patients had no soiling during the daytime, and 45% were fully continent day and night. After 3 months 89% had recovered the ability to distinguish flatus from feces.


CONCLUSIONS
Ileal pouch anal anastomosis can be performed safely without diverting ileostomy using an ultrasonically activated scalpel. The postoperative functional result was stabilized 3 months after the operation.
Ikeuchi
Hiroki
H
Second Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cyo, Nisinomiya, 663-8501 Hyogo, Japan. ikeuci2s@hyo-med.ac.jp
Shoji
Yasutsugu
Y
Kusunoki
Masato
M
Yanagi
Hidenori
H
Noda
Masafumi
M
Yamamura
Takehira
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D003093:Colitis, Ulcerative / Q000601:surgery*; D003672:Defecation / Q000502:physiology; D005260:Female; D006801:Humans; D007239:Infections / Q000209:etiology; D007413:Intestinal Mucosa / Q000601:surgery; D007415:Intestinal Obstruction / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010388:Pelvis; D010538:Peritonitis / Q000209:etiology; D016737:Proctocolectomy, Restorative / Q000009:adverse effects / Q000379:methods*; D018805:Sepsis / Q000209:etiology; D013529:Surgical Wound Dehiscence / Q000209:etiology; D000267:Tissue Adhesions / Q000209:etiology / Q000601:surgery; D016896:Treatment Outcome