Risultati clinici e funzionali dopo proctocolectomia restaurativa con serbatoio ileale a J nel trattamento delia colite ulcerosa

Translated title of the contribution: Clinical and functional results after stapled restorative proctocolectomy with ileal J pouch for ulcerative colitis

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

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Restorative proctocolectomy is the procedure of choice in the treatment of ulcerative colitis. The operation is successful in removing all diseased mucosa while preserving a normal bowel function and a good quality of life for the patient. In this article are presented the clinical and functional results obtained in 28 patients, 19 males (68%) and 9 females (32%) after stapled restorative proctocolectomy with ileal J pouch-anal anastomosis. Results: There were no perioperative deaths. The overall morbidity rate was 31%. Six patients (21%) presented pelvic abscess; 2 (7%) pelvic hematoma, 4 patients (14%) ileo-anal anastomotic stricture, 1 patient (3,6%) pouchvagina fistula, three patients (11%) intestinal obstruction and 7 (25%) pouchitis. All patients were able to evacuate their pouches spontaneously. The mean bowel movements were 6-9/24 hours at the first postoperative month and 3-5/24 hours at the sixth month. Infrequent nocturnal seepage occurred in 6 patients (21%). Stool consistency returned to normal within 3-6 months. The mean pouch capacity was 210 cc. The mean resting pressure was diminished in 11 patients (39%), the men and maximal squeeze pressures were improved in 9 (32%); the ileo-rectal-anal inhibitory reflex was normal in 5 patients (18%), not defined in 12 (43%), Impotence or impaired bladder function was not present. Conclusion: The use of staplers in the surgical technique of restorative proctocolectomy with J shaped ileo-anal pouch is associated with low morbidity and better long-term results. The procedure requires a good selection of patients, a correct surgical timing, a very carefully technique and a low pre and postoperative treatment with steroids.

Translated title of the contributionClinical and functional results after stapled restorative proctocolectomy with ileal J pouch for ulcerative colitis
Original languageItalian
Pages (from-to)287-296
Number of pages10
JournalAnnali Italiani di Chirurgia
Volume73
Issue number3
Publication statusPublished - May 2002

ASJC Scopus subject areas

  • Surgery

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