title: Clinical outcomes after restorative proctocolectomy with ileal pouch anal anastomosis using ultrasonically activated scalpel for ulcerative colitis.
abstract: We compared 3 different initial operative procedures performed in patients with ulcerative colitis who underwent an ileal pouch anal anastomosis (IPAA) procedure with a Harmonic Scalpel (HS). We selected 775 patients who underwent a restorative proctocolectomy with a mucosectomy using an HS and hand-sewn IPAA. Ninety-six patients underwent a total colectomy (3-stage procedure) as the initial operation, whereas 258 underwent IPAA without ileostomy (1-stage procedure) and 421 underwent IPAA with ileostomy (2-stage procedure). There were no significant differences regarding early pouch functional rate among the 3 groups. After 5 years with a functioning ileal pouch, the survival rates for the total colectomy, IPAA with ileostomy, and IPAA without ileostomy groups were 100%, 99.3%, and 99.0%, respectively. There was low operative mortality, and acceptable rates of early and late complications in patients with ulcerative colitis who underwent a restorative proctocolectomy and IPAA using an HS.
authors.affiliation: Inflammatory Bowel Disease Center, Hyogo College of Medicine, Hyogo, Japan. ikeuci2s@hyo-med.ac.jp
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ikeuchi
authors.forename: Motoi
authors.initials: M
authors.lastname: Uchino
authors.forename: Hiroki
authors.initials: H
authors.lastname: Matsuoka
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Bando
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Takesue
authors.forename: Naohiro
authors.initials: N
authors.lastname: Tomita
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy; D003093:Colitis, Ulcerative / Q000401:mortality / Q000601:surgery*; D039021:Colonic Pouches; D005260:Female; D006801:Humans; D007081:Ileostomy; D007413:Intestinal Mucosa / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016737:Proctocolectomy, Restorative / Q000295:instrumentation*; D016896:Treatment Outcome; D059708:Ultrasonic Surgical Procedures / Q000295:instrumentation*