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J pouch with ileoanal anastomosis
1Department of Surgery, Mayo Clinic, Rochester, Minn. 55901.
Canadian Journal of Surgery. Journal Canadien De Chirurgie
|September 1, 1987
Summary
The ileoanal J-pouch procedure offers a more acceptable alternative to ileostomy, with 95% of patients reporting improved quality of life. Careful patient selection is crucial for successful ileoanal anastomosis outcomes.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Patient Quality of Life
Background:
- Ileostomy presents significant physical and psychological challenges for patients.
- The need for a more normalized and acceptable surgical alternative to ileostomy is well-established.
Purpose of the Study:
- To report the Mayo Clinic's experience with the ileoanal reservoir (J-pouch) procedure.
- To detail modifications and assess outcomes of the J-pouch construction.
Main Methods:
- Retrospective review of 188 patient charts who underwent J-pouch construction.
- Description of the operative technique employed.
Main Results:
- No hospital deaths occurred.
- The procedure failed in 10 patients.
- Complications included pelvic sepsis (21), anastomotic sinus (15), anastomotic stricture (22), small-bowel obstruction (43), peritonitis after ileostomy closure (10), and pouchitis (15).
Conclusions:
- The ileoanal anastomosis is a viable alternative to loop ileostomy, with 95% of patients finding life more acceptable.
- Crohn's disease is a contraindication for this procedure.
- Careful patient selection is paramount for successful ileoanal reservoir outcomes.