title: [Application of ileal D-pouch anal anastomosis in the treatment of ulcerative colitis and familial adenomatous polyposis].
abstract: OBJECTIVE
  To evaluate the clinical outcomes of ileal D-pouch anal anastomosis in the treatment of ulcerative colitis (UC) and familial adenomatous polyposis (FAP).
  
  
  METHODS
  Clinical and follow-up data of 6 UC patients and 5 FAP patients undergoing proctocolectomy and D-ileum pouch anal anastomosis between October 2014 and March 2015 were retrospectively analyzed. End-to-side anastomosis was firstly performed in ileal cutting end and ileum, then side-to-side anastomosis was operated in closing amphi-loop to construct the D-ileum pouch.
  
  
  RESULTS
  The mean age of the patients was 42 years (range 18 to 61 years), 5 patients were female. The duration of surgery was (225±23) min, the operation time to D-ileum pouch was (18±4) min, the volume of D-ileum pouch was (175±15) ml, the blood loss was (110±30) ml. There was no procedure-related death, however rectum perforation occurred in 1 male UC patient during operation. The postoperative hospital stay was 8 to 11 days (mean 8.5 days). The follow-up period was 2 to 7 months (median 3 months). One female FAP patient suffered from anal anastomosis vagina fistula 21 days after operation. No pouch-related fistula, anastomosis or input loop stricture fecal incontinence, and severe pouchitis were recorded. The defecation frequency was 4 to 6 times per day (UC) and 3 to 5 times per day (FAP) 6 months after operation. No night-time fecal leakage was complained in those patients. Wexner incontinence score was 3±2 and GQLI was 114±11 one month after operation. Clinical outcome in the first month was excellent in 10 patients and good in 1 patient.
  
  
  CONCLUSIONS
  After total colorectal resection for UC and FAP patients, application of D-ileum pouch can clear ileal stump of pouch and avoid the pouch-associated complications effectively.
authors.affiliation: Department of Colorectal Surgery, Zhongnan Hosipital, Wuhan University, Wuhan 430071, China. chqjiang@hotmail.com.
authors.forename: Zhao
authors.initials: Z
authors.lastname: Ding
authors.forename: Yunhua
authors.initials: Y
authors.lastname: Wu
authors.forename: Qianbo
authors.initials: Q
authors.lastname: Qin
authors.forename: Keyan
authors.initials: K
authors.lastname: Zheng
authors.forename: Weicheng
authors.initials: W
authors.lastname: Liu
authors.forename: Qun
authors.initials: Q
authors.lastname: Qian
authors.forename: Congqing
authors.initials: C
authors.lastname: Jiang
mesh_terms: D011125:Adenomatous Polyposis Coli; D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical; D003093:Colitis, Ulcerative; D039021:Colonic Pouches; D005242:Fecal Incontinence; D005260:Female; D006801:Humans; D007082:Ileum; D008297:Male; D008875:Middle Aged; D019449:Pouchitis; D016737:Proctocolectomy, Restorative; D012003:Rectal Fistula; D012189:Retrospective Studies; D014621:Vagina; D055815:Young Adult