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The ileoanal reservoir
S D Wexner1, W D Wong, D A Rothenberger
1Department of Colorectal Surgery, Cleveland Clinic Florida, Fort Lauderdale.
American Journal of Surgery
|January 1, 1990
Summary
The ileoanal reservoir is a viable surgical option for ulcerative colitis, offering good long-term function for most patients. However, it is not suitable for all individuals, requiring careful patient selection.
Area of Science:
- Gastroenterology and Surgical Innovation
- Colorectal Surgery Outcomes
Background:
- Mucosal ulcerative colitis management often involves surgical interventions.
- The ileoanal reservoir is an alternative to permanent ileostomy.
Purpose of the Study:
- To evaluate the long-term functional outcomes and complications of ileoanal reservoirs.
- To assess patient satisfaction with ileoanal reservoirs compared to permanent ileostomies.
Main Methods:
- Retrospective analysis of 186 patients (109 men, 71 women) undergoing ileoanal reservoir construction.
- Follow-up evaluation of functional outcomes and complications for a mean of 5 years post-ileostomy closure.
Main Results:
- Postoperative complications included small bowel obstruction (11%) and sepsis (11%).
- Long-term, 27% experienced small bowel obstruction, requiring enterolysis/enterectomy in 15%.
- Functional outcomes improved or remained stable in 96% of patients; 95% would choose the reservoir again.
Conclusions:
- The ileoanal reservoir is a viable option for ulcerative colitis, with high patient satisfaction and good long-term function.
- Careful patient selection is crucial, as the procedure is not universally recommended.