title: Intestinal pouch complications in patients who underwent restorative proctocolectomy for ulcerative colitis and familial adenomatous polyposis in 1985-2008.
abstract: Restorative proctocolectomy is considered a surgical treatment of choice in ulcerative colitis (UC) and familial adenomatous polyposis (FAP).The aim of the study was to evaluate postoperative complications in patients who underwent surgery for familial adenomatous polyposis and ulcerative colitis, on the basis of a retrospective data analysis.
  
  
  METHODS
  Data of 138 patients after restorative proctocolectomy performed between 1985 and 2008 were collected at routine follow-up visits in 2004-2008. We evaluated the presence of pouchitis, the degree of ileal pouch mucosa atrophy, the presence of ileal pouch mucosal metaplasia, the presence of ileal pouch malignancies, the necessity for diverting ileostomy, the necessity for pouch resection, and severe faecal incontinence.
  
  
  RESULTS
  Complications were observed in 45 (32.4%) patients. Thirty-seven patients developed pouchitis (26.6%). Low-degree dysplasia, severe dysplasia or malignancies were observed in total in 20 patients (14.4%). Six (4.3%) operated patients developed other analysed complications.
  
  
  CONCLUSIONS
  The most common complications of restorative proctocolectomy were dysplasia and pouchitis. The most common complication in patients operated for UC was pouchitis. The low observed incidence of intestinal pouchitis may be attributed to the implemented prophylaxis of inflammation. Dysplasia was the most common complication in patients undergoing proctocolectomy for FAP. Due to an increased risk of dysplastic lesions as compared with UC patients, careful endoscopic follow-up examinations are obligatory in this patient group. Other analysed complications were uncommon and were mostly a consequence of chronic pouchitis. Clinical symptoms of pouch-related problems were similar in both analysed groups.
authors.affiliation: Department of General and Colorectal Surgery, Medical University in Poznań.
authors.forename: Robert
authors.initials: R
authors.lastname: Burdyński
authors.forename: Tomasz
authors.initials: T
authors.lastname: Banasiewicz
authors.forename: Ryszard
authors.initials: R
authors.lastname: Marciniak
authors.forename: Maciej
authors.initials: M
authors.lastname: Biczysko
authors.forename: Jacek
authors.initials: J
authors.lastname: Szmeja
authors.forename: Jacek
authors.initials: J
authors.lastname: Paszkowski
authors.forename: Marcin
authors.initials: M
authors.lastname: Grochowalski
authors.forename: Jakub
authors.initials: J
authors.lastname: Maik
authors.forename: Przemysław
authors.initials: P
authors.lastname: Majewski
authors.forename: Piotr
authors.initials: P
authors.lastname: Krokowicz
authors.forename: Michał
authors.initials: M
authors.lastname: Drews
mesh_terms: D011125:Adenomatous Polyposis Coli / Q000601:surgery*; D000328:Adult; D001003:Anal Canal / Q000601:surgery; D003093:Colitis, Ulcerative / Q000601:surgery*; D039021:Colonic Pouches / Q000009:adverse effects* / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D019449:Pouchitis / Q000209:etiology* / Q000628:therapy; D016737:Proctocolectomy, Restorative / Q000009:adverse effects* / Q000379:methods; D011788:Quality of Life; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult