The ileal pouch-anal anastomosis: surgical technique and current clinical results

During the six-year period between January 1981 and January 1987, 582 ileal pouch-anal anastomoses were constructed at the Mayo Clinic-affiliated hospitals for either ulcerative colitis (509 patients) or polyposis coli (71 patients). Two patients had Crohn's disease. Two patients died postoperatively. Pelvic sepsis, intestinal obstruction, and pouchitis were seen in 4%, 13%, and 14%, respectively. At one year postoperatively, the mean number of stools was 5.6 during the day and 1.5 during the night. Younger patients and those with polyposis had fewer stools. Incontinence was observed in 2% patients during the day and 3% during the night. Ileal pouch-anal anastomosis is safe, provides satisfactory continence, and improves the quality of life of patients who require proctocolectomy.