Aspetti delle complicanze dopo proctocolectomia restaurativa nel trattamento della colite ulcerosa. Revisione della letteratura ed esperienza personale

Translated title of the contribution: Analysis of complications and causes of failure after restorative proctocolectomy for ulcerative colitis. Personal experience

P. L. Colombo, F. P. Tinozzi, M. Abelli, M. R. Laera, G. Testone, P. Moglia, S. Albertario, G. Morone, C. Bianchi, S. Tinozzi

Research output: Contribution to journalArticle

Abstract

Purpose: Analysis of complications and causes of failure after stapled restorative proctocolectomy with ileal J pouchanal anastomosis in patients with ulcerative colitis is presented. Patients and Methods: The procedure was performed in 28 patients, 19 males (68%) and 9 females (32%); diverting ileostomy was always performed. Results: There was no perioperative mortality. The overall morbidity rate was 31%. Six patients (21%) had pelvic abscess, 2 (7%) pelvic hematoma, 4 patients (14%) presented ileo-anal anastomotic stricture, J patient (3,6%)) had pouch-vaginal fistula, three patients (11 %) presented intestinal obstruction and 7 (25%) pouchitis. Reoperation was necessary in patients with small bowel obstruction and with pouch-vaginal fistula. Septic complications and pouchitis were resolved with medical treatment. Stenosis of the anastomosis required anal dilation. No patient underwent pouch excision for pouch failure. Conclusion: The main significant complications of ileal pouch-anal anastomosis for ulcerative colitis were pelvic sepsis, intestinal obstruction and pouchitis. Our results suggest that the use of stapling technique is safer and has fewer early septic complications and sepsis-related pouch removals. Success in ileo-anal construction increases with experience. The selection of patients with exclusion of Crohn disease, a correct surgical timing, a carefully technique, a delayded ileostomy closure and a low pre and postoperative regimen of steroids are important factors of success.

Translated title of the contributionAnalysis of complications and causes of failure after restorative proctocolectomy for ulcerative colitis. Personal experience
Original languageItalian
Pages (from-to)161-171
Number of pages11
JournalAnnali Italiani di Chirurgia
Volume73
Issue number2
Publication statusPublished - 2002

ASJC Scopus subject areas

  • Surgery

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    Colombo, P. L., Tinozzi, F. P., Abelli, M., Laera, M. R., Testone, G., Moglia, P., Albertario, S., Morone, G., Bianchi, C., & Tinozzi, S. (2002). Aspetti delle complicanze dopo proctocolectomia restaurativa nel trattamento della colite ulcerosa. Revisione della letteratura ed esperienza personale. Annali Italiani di Chirurgia, 73(2), 161-171.