The effect of diverticular disease on the colonic J pouch.
OBJECTIVE
The aim of this study was to assess the impact of the diverticular disease (DD) on function and on postoperative complications of the colonic J-pouch (CJP) with pouch-anal anastomosis.


METHODS
Patients who underwent a CJP between December 1990 and August 2001, were retrospectively reviewed. The presence of DD in the CJP was assessed on pouchogram prior to ileostomy closure. A questionnaire designed to evaluate the degree of continence (total incontinence score (IS): 0 = worst, 20 = best) and pouch evacuation (total evacuation score (ES): 0 = worst, 28 = best) was used for comparison between patients with DD and those without DD (NDD).


RESULTS
Sixty-six patients (47 males; 19 females) with a median age of 68 years (range 28-87 years) were included. The median follow-up period was 22 months (range 2-106 months). Twenty-four patients comprised the DD group and 42 were in the NDD group. The two groups were comparable for age, gender and time from ileostomy closure; all patients with postoperative chemoradiation therapy were in the NDD group. The total ES and IS total did not significantly differ between the two groups with a P-value of 0.11 and 0.09 respectively. Furthermore, there was no significant difference in the total incidence of pouch complications between the two groups (3 strictures, 1 leak, 1 fistula in the NDD group vs. 1 pelvic sepsis in the DD group; P = 0.4).


CONCLUSIONS
The presence of DD in a CJP does not seem to impact pouch function or the postoperative complication rate.
da Silva
G M
GM
Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL 33331, USA.
Kaiser
R
R
Börjesson
L
L
Colqhoun
P
P
Lobo
C
C
Khandwala
F
F
Thornton
J
J
Efron
J
J
Vernava
A M
AM
Weiss
E G
EG
Wexner
S D
SD
Gervaz
P
P
Nogueras
J J
JJ
D000368:Aged; D001003:Anal Canal / Q000503:physiopathology* / Q000601:surgery*; D000714:Anastomosis, Surgical; D016022:Case-Control Studies; D039021:Colonic Pouches / Q000502:physiology*; D003251:Constriction, Pathologic / Q000150:complications / Q000532:radiotherapy / Q000601:surgery; D003672:Defecation; D004241:Diverticulum, Colon / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012004:Rectal Neoplasms / Q000150:complications / Q000532:radiotherapy / Q000601:surgery; D012189:Retrospective Studies