title: Restorative proctocolectomy: the current ochsner experience.
abstract: BACKGROUND
  Restorative proctocolectomy with an ileal pouch-anal anastomosis is a technically demanding procedure to treat ulcerative colitis and familial adenomatous polyposis. Since its initial description almost 30 years ago, the operation has undergone technical and perioperative modifications to improve the patient's experience.
  
  
  METHODS
  We performed a retrospective review of the records of patients undergoing restorative proctocolectomy at the Ochsner Clinic Foundation Hospital from 2008 to 2012 and compared data from that period to data from 1989-1995 (prior to laparoscopic pouch surgery) to determine factors associated with patient outcome.
  
  
  RESULTS
  Ileal pouch-anal procedures were performed in 77 patients. The 30 male and 47 female patients ranged in age from 13 to 63 years (mean, 34.5 years). The indications for the procedure were ulcerative colitis in 62 patients, polyposis coli in 12 patients, and Crohn disease in 3 patients. Forty patients (52%) had laparoscopic-assisted procedures. The overall hospital length of stay for pouch creation averaged 6.9 days (range 3-29) and for ileostomy closure averaged 4.3 days (range 1-15). No perioperative deaths occurred within 30 days. Complications occurred in 37.7% of patients. Compared to a previous report of 72 patients from 1989 to 1995, the recent group had more laparoscopic procedures, shorter hospital stays, a smaller percentage of 3-stage procedures, and fewer general and pouch-related complications. Pouch failures were similar for both groups.
  
  
  CONCLUSIONS
  Advances in operative techniques and perioperative management have improved the outcome of restorative proctocolectomies.
authors.affiliation: Department of General Surgery, Ochsner Clinical School, New Orleans, LA.
authors.forename: Shahrazad
authors.initials: S
authors.lastname: Talebinejad
authors.affiliation: Department of Colon and Rectal Surgery, Ochsner Clinic Foundation, Ochsner Clinical School, New Orleans, LA.
authors.forename: Terry C
authors.initials: TC
authors.lastname: Hicks
authors.affiliation: Department of Colon and Rectal Surgery, Ochsner Clinic Foundation, Ochsner Clinical School, New Orleans, LA ; The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.
authors.forename: David A
authors.initials: DA
authors.lastname: Margolin
authors.affiliation: Department of Colon and Rectal Surgery, Ochsner Clinic Foundation, Ochsner Clinical School, New Orleans, LA.
authors.forename: Charles B
authors.initials: CB
authors.lastname: Whitlow
authors.affiliation: Department of Colon and Rectal Surgery, Ochsner Clinic Foundation, Ochsner Clinical School, New Orleans, LA.
authors.forename: H David
authors.initials: HD
authors.lastname: Vargas
authors.affiliation: Department of Colon and Rectal Surgery, Ochsner Clinic Foundation, Ochsner Clinical School, New Orleans, LA ; The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA.
authors.forename: David E
authors.initials: DE
authors.lastname: Beck
keywords: Anastomosis—surgical; colonic pouches; laparoscopy; postoperative complications; proctocolectomy—restorative