Current controversies in pouch surgery.

Abstract:

:Restorative proctocolectomy with ileal pouch anal anastomosis has become the most commonly used procedure for elective treatment of patients with mucosal ulcerative colitis and familial adenomatous polyposis. Since its original description, the procedure has been modified in an attempt to obtain optimal functional results with low morbidity and mortality, and yet provide a cure for the disease. These modifications of the technique are discussed in this review, limited to the current points of controversy. We reviewed the current literature describing restorative proctocolectomy with ileal pouch anal anastomosis. The current "hot topics" for debate are transanal mucosectomy with hand-sewn anastomosis versus the double-stapled technique, the use of diverting ileostomy, indeterminate colitis, the role of laparoscopy, and indications for pouch surgery in the elderly. Longer follow-up of patients and increased knowledge and experience with pouch surgery, coupled with active prospective evaluation of the procedure are required to settle these issues. Patients must be fully informed to understand inherent risks of each choice.

journal_name

South Med J

journal_title

Southern medical journal

authors

Garbus JE,Potenti F,Wexner SD

doi

10.1097/01.SMJ.0000047720.97917.03

subject

Has Abstract

pub_date

2003-01-01 00:00:00

pages

32-6

issue

1

eissn

0038-4348

issn

1541-8243

journal_volume

96

pub_type

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