S-pouches vs. J-pouches. A comparison of functional outcomes

Subjects undergoing proctocolectomy with ileoanal anastomosis of either a J-shaped or an S-shaped ileal reservoir were studied with respect to functional status. Both subjective and objective measures were used. The S-pouch subjects appeared to have better early functional results, but no differences were found between groups evaluated at least one year from ileostomy closure. While virtually all subjects preferred restorative proctocolectomy to their previous loop ileostomy, there was a relatively high frequency of bowel-related symptoms, worries about bowel activity, and associated behavioral changes. The actual significance of these symptoms is difficult to determine at present. Further assessment of the quality of life in individuals with restorative proctocolectomy in comparison with subjects undergoing alternative surgical treatments is recommended.