[Technique and results of the ileoanal pouch after proctocolectomy]

Nowadays restorative proctocolectomy and ileal pouch-anal anastomosis represent the standard procedure in the treatment for ulcerative colitis and familial polyposis. Although various pouchdesigns are described, the J-pouch is the one most frequently used. This study reviewed 311 operations of restorative proctocolectomy and ileal pouch-anal anastomosis between January 82 and December 93. The indication was ulcerative colitis in 234 and familial polyposis in 77 cases. In 67% of the cases the standard two-stage procedure involving secondary ileostomy closure was chosen. Due to the complex nature of the operation, postoperative morbidity--which is higher for ulcerative colitis--must not be undermined. Complete exstirpation of the pouch was required in 4.2% of the patients with ulcerative colitis and in one case with familial polyposis. In 12.4% and 1.3% a severe pouchitis was found in ulcerative colitis and familial polyposis respectively. In general postoperative functional results were satisfactory. Continence was established in over 90% of the patients while the mean stool frequency was 6 per day.