Ileal pouch-anal anastomosis for chronic ulcerative colitis. Long-term results.

Abstract:

:The aim of this study was to determine the long-term outcome among 390 patients with ulcerative colitis who underwent ileal J pouch-anal anastomosis and whether patient or operative factors influenced results. The combined operative morbidity rate for the pouch-anal anastomosis and the subsequent closure of the temporary ileostomy was 29% (bowel obstruction, 22%; pelvic sepsis, 5%), with one death due to pulmonary embolus. The probability of a successful outcome at 5 years was 94%. Of the 24 patients who failed (6% of total), 18 did so within 1 year (4%), three during year 2 (1%), three during year 3 (1%), and none thereafter. Stool frequency (7 stools/24 h), the occurrence of pouchitis (14%), and satisfactory daytime continence (94% of patients) remained stable over 4 years after operation, whereas nocturnal fecal spotting decreased (51% of patients to 20%). Women had more spotting than men, whereas patients over 50 years old had more stools per day than those 50 years or younger. In conclusion, ileal pouch-anal anastomosis achieved a reasonable stool frequency and satisfactory continence in patients with ulcerative colitis over the long-term. These results support the ileal pouch-anal anastomosis as a safe, satisfactory alternative to permanent ileostomy.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Pemberton JH,Kelly KA,Beart RW Jr,Dozois RR,Wolff BG,Ilstrup DM

doi

10.1097/00000658-198710000-00011

subject

Has Abstract

pub_date

1987-10-01 00:00:00

pages

504-13

issue

4

eissn

0003-4932

issn

1528-1140

journal_volume

206

pub_type

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