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Related Experiment Videos

Fistula complicating restorative proctocolectomy

M R Keighley1, S P Grobler

  • 1Department of Surgery, Queen Elizabeth Hospital, Birmingham, UK.

The British Journal of Surgery
|August 1, 1993
PubMed
Summary

Fistulas after restorative proctocolectomy are complications. Surgical management of enterocutaneous, pouch-vaginal, and pouch-perineal fistulas can achieve good pouch function.

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Colorectal Surgery

Background:

  • Restorative proctocolectomy is a surgical procedure for ulcerative colitis and familial adenomatous polyposis.
  • Fistula formation is a known complication following restorative proctocolectomy.

Purpose of the Study:

  • To analyze the incidence, types, origins, and management outcomes of fistulas after restorative proctocolectomy.

Main Methods:

  • Retrospective review of 168 restorative proctocolectomies.
  • Classification of fistulas based on type, origin, and patient comorbidities.
  • Evaluation of surgical interventions and functional outcomes.

Main Results:

  • Twenty-seven patients developed fistulas.
  • Enterocutaneous fistulas (n=13) originated from various sites including the pouch and anastomosis.
  • Pouch-vaginal fistulas (n=10) and pouch-perineal fistulas (n=3) were primarily associated with the ileoanal anastomosis.
  • Surgical management, including excision and fistulotomy, led to satisfactory pouch function in most cases.

Conclusions:

  • Fistulas are a significant complication after restorative proctocolectomy.
  • Diverse fistula types require tailored surgical approaches.
  • Successful management of fistulas generally preserves pouch function, even in complex cases.

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