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Experience with restorative proctocolectomy in 201 patients
1Second Department of Surgery, Helsinki University Central Hospital, Finland.
Annales Chirurgiae Et Gynaecologiae
|January 1, 1993
Summary
Restorative proctocolectomy with J-pouch anal anastomosis is a safe and effective procedure for ulcerative colitis and familial adenomatous polyposis. This surgical approach offers good functional outcomes and is now a preferred treatment option.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Colorectal Surgery
Background:
- Restorative proctocolectomy is a surgical option for patients with ulcerative colitis and familial adenomatous polyposis.
- The J-pouch anal anastomosis is a common technique used in this procedure.
Purpose of the Study:
- To evaluate the outcomes of restorative proctocolectomy with J-pouch anal anastomosis.
- To assess the safety, efficacy, and functional results of this surgical approach.
Main Methods:
- A retrospective review of 201 patients who underwent restorative proctocolectomy between 1985 and 1993.
- Patients had either ulcerative colitis (191) or familial adenomatous polyposis (10).
- Total mucosectomy was performed in all but 22 patients.
Main Results:
- The procedure had a 99.5% technical success rate with no postoperative mortality.
- Early complications occurred in 33% of patients, with 21% requiring reoperation.
- Late morbidity was 29%, including pouchitis (20%) and anal sinus issues (11%).
- Functional outcomes at one year showed a mean bowel frequency of 5.6/24 hours, with 19% experiencing minor anal soiling.
Conclusions:
- Restorative proctocolectomy with J-pouch anal anastomosis is a safe and effective procedure.
- It is associated with acceptable morbidity and good functional outcomes.
- This surgical approach has become the first choice for most patients with ulcerative colitis and familial adenomatous polyposis.