BACKGROUND: Restorative proctocolectomy is now the operation of choice for the definitive management of ulcerative colitis and familial adenomatous polyposis (FAP). METHODS: A total of 200 patients (117 male, 83 female) underwent restorative proctocolectomy over a 12-year period. Information in a dedicated prospective database was supplemented by chart review. Some 177 had ulcerative colitis, 13 had indeterminate colitis and seven had FAP. Pouch designs were two-loop J (n = 142), four-loop W (n = 45) and three-loop S (n = 13). The majority (73.5 per cent) had a stapled ileoanal anastomosis and 139 patients had a defunctioning ileostomy. RESULTS: There were no deaths. Early morbidity (less than 30 days after operation) included 76 complications in 71 patients (35.5 per cent), of which 35 were related to the pouch itself. Long-term follow-up data were available for 196 patients at a median of 27 months. Sixteen pouches (8.0 per cent) have been excised. Mean daytime frequency was 4.5 (range 1-15). Of 175 patients with colitis, 42 (24.0 per cent) had one or more episodes of pouchitis. CONCLUSION: Continuous improvements in operative technique have simplified the procedure, and functional results, although variable, have generally been acceptable.
BACKGROUND: Restorative proctocolectomy is now the operation of choice for the definitive management of ulcerative colitis and familial adenomatous polyposis (FAP). METHODS: A total of 200 patients (117 male, 83 female) underwent restorative proctocolectomy over a 12-year period. Information in a dedicated prospective database was supplemented by chart review. Some 177 had ulcerative colitis, 13 had indeterminate colitis and seven had FAP. Pouch designs were two-loop J (n = 142), four-loop W (n = 45) and three-loop S (n = 13). The majority (73.5 per cent) had a stapled ileoanal anastomosis and 139 patients had a defunctioning ileostomy. RESULTS: There were no deaths. Early morbidity (less than 30 days after operation) included 76 complications in 71 patients (35.5 per cent), of which 35 were related to the pouch itself. Long-term follow-up data were available for 196 patients at a median of 27 months. Sixteen pouches (8.0 per cent) have been excised. Mean daytime frequency was 4.5 (range 1-15). Of 175 patients with colitis, 42 (24.0 per cent) had one or more episodes of pouchitis. CONCLUSION: Continuous improvements in operative technique have simplified the procedure, and functional results, although variable, have generally been acceptable.
Authors: Udo A Heuschen; Ulf Hinz; Erik H Allemeyer; Frank Autschbach; Josef Stern; Matthias Lucas; Christian Herfarth; Gundi Heuschen Journal: Ann Surg Date: 2002-02 Impact factor: 12.969
Authors: Edward L Barnes; Hans H Herfarth; Robert S Sandler; Wenli Chen; Elizabeth Jaeger; Van M Nguyen; Amber R Robb; Michael D Kappelman; Christopher F Martin; Millie D Long Journal: Inflamm Bowel Dis Date: 2017-07 Impact factor: 5.325
Authors: Simon D McLaughlin; Alan W Walker; Carol Churcher; Susan K Clark; Paris P Tekkis; Matthew W Johnson; Julian Parkhill; Paul J Ciclitira; Gordon Dougan; Ralph John Nicholls; Liljana Petrovska Journal: Ann Surg Date: 2010-07 Impact factor: 12.969
Authors: T Mimura; F Rizzello; U Helwig; G Poggioli; S Schreiber; I C Talbot; R J Nicholls; P Gionchetti; M Campieri; M A Kamm Journal: Gut Date: 2004-01 Impact factor: 23.059