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Totally stapled abdominal restorative proctocolectomy.

W A Kmiot1, M R Keighley

  • 1General Hospital, Birmingham, UK.

The British Journal of Surgery
|September 1, 1989
PubMed
Summary
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This study reports a stapled restorative proctocolectomy technique for 20 patients. It shows promise for pouch construction without ileostomy in suitable patients not on steroids.

Area of Science:

  • Gastroenterology
  • Surgical Innovation

Background:

  • Restorative proctocolectomy is a surgical option for ulcerative colitis and familial adenomatous polyposis.
  • Stapled ileoanal anastomosis aims to improve functional outcomes and reduce complications.

Purpose of the Study:

  • To evaluate the safety and efficacy of a totally stapled abdominal restorative proctocolectomy with a J-pouch and stapled ileoanal anastomosis.
  • To assess the need for a covering ileostomy and postoperative complications.

Main Methods:

  • A consecutive series of 20 patients underwent totally stapled restorative proctocolectomy.
  • A 20 x 20 cm J-pouch and stapled ileoanal anastomosis were utilized.
  • Patient data including operative time, hospital stay, and complications were recorded.

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Main Results:

  • The stapled ileoanal anastomosis was successfully completed in 17 of 20 patients.
  • Three patients experienced serious postoperative morbidity, all of whom were receiving steroids.
  • No serious complications occurred in the 13 patients not receiving steroids, with a median hospital stay of 14 days.

Conclusions:

  • Totally stapled restorative proctocolectomy is a viable technique, particularly for patients not on steroids.
  • Avoiding a covering ileostomy is feasible in selected patients.
  • Steroid use may be associated with increased postoperative morbidity.