Alterations in ileoanal pouch technique, 1980 to 1987. Complications and functional outcome

This study presents the results of 82 ileoanal pouch operations (57 S, 25 J) performed from 1980 to 1987. It also reports the development of the operative technique during these years. The functional outcome was evaluated in 66 patients followed for 2 to 84 months (mean, 23). The mean number of bowel movements per 24 hours was 5.0. Seventy-four percent of the patients had no leakage or staining and 82 percent had a deferral time of more than one hour. Nightly evacuations were significantly more common in men than in women. Leakage and short deferral time were significantly more common in patients over 40 years of age than in those under 25. Early experience with the S-pouch was encumbered by evacuation problems and ileoanal separations. Shortening of the efferent conduits and the muscle cuffs reduced these complications significantly. Postoperative continence was improved significantly after reduction of anal dilatation and preservation of the transitional zone. The length of bowel used for the double-loop reservoirs seemed to be of importance concerning frequency.