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Restorative proctocolectomy: a procedure for the district general hospital?
B R Davidson1, J Thornton-Holmes
1Surgical Unit, Peterborough District Hospital, UK.
International Journal of Colorectal Disease
|February 1, 1990
Summary
Restorative proctocolectomy, a key surgery for ulcerative colitis and familial adenomatous polyposis, can be safely performed in District General Hospitals. This study shows favorable outcomes for total colectomy and ileoanal anastomosis outside specialized centers.
Area of Science:
- Colorectal Surgery
- Gastroenterology
- Surgical Outcomes
Background:
- Restorative proctocolectomy is the standard surgical treatment for ulcerative colitis and familial adenomatous polyposis.
- Most procedures are performed in specialized regional centers.
Purpose of the Study:
- To evaluate the feasibility and outcomes of restorative proctocolectomy performed at a District General Hospital (DGH).
- To assess the safety and functional results of total colectomy and ileoanal anastomosis (TC-IA) outside specialized units.
Main Methods:
- Retrospective review of 17 patients undergoing TC-IA between 1981 and 1989 at a DGH.
- Analysis of operative outcomes, complications, and long-term functional results (stool frequency, continence).
Main Results:
- No operative or perioperative deaths occurred in 17 patients.
- Two patients required re-operation for adhesions and pelvic sepsis.
- At a mean follow-up of 5 years, 16 patients reported a median of 5 stools daily, with 12 having spontaneous defecation. No patient experienced incontinence.
Conclusions:
- Total colectomy and ileoanal anastomosis can be performed successfully outside specialized centers.
- Restorative proctocolectomy at a DGH can achieve good functional outcomes and patient satisfaction.