[The ileoanal reservoirs as a rectal replacement. The late complications and long-term functional results]

Late complications and functional results in 44 consecutive patients (17 women, 27 men; mean age 36 years) were collected prospectively after continence-preserving proctocolectomy for ulcerative colitis. In all patients a J-pouch was placed by direct end-to-side machine-stapled anastomosis without rectal cuff. 5 years postoperatively 12 of 13 (92%) were totally continent during the day, 11 of 13 (85%) at night. Stool frequency at that time was 6.3 +/- 2 per 24 hours; 4 patients (31%) had on average one motion during the night. Lasting sexual dysfunction occurred in three men. Fistulae, as a result of previously undiagnosed Crohn's disease, developed postoperatively in three patients: between pouch and vagina in one, between pouch and bladder in another. The pouch had to be removed in both instances. In the third patient an enterocutaneous fistula was closed. If strict indications are followed, the clinical and functional results of a pelvic ileoanal reservoir meet the daily demands of life at both a professional and social level.