An audit of restorative proctocolectomy

Area of Science:

• Surgical Gastroenterology
• Colorectal Surgery
• Surgical Outcomes Research

Background:

• Restorative proctocolectomy is a complex surgical procedure.
• Long-term outcomes and complication rates require ongoing evaluation.

Purpose of the Study:

• To analyze the outcomes and complications of restorative proctocolectomy over a nine-year period.
• To identify factors influencing success and failure rates.

Main Methods:

• Retrospective analysis of 168 restorative proctocolectomy cases.
• Review of patient data, including morbidity, reoperation rates, and long-term functional outcomes.

Main Results:

• Zero mortality reported; significant reduction in pelvic sepsis, ileoanal stricture, and fistula rates with increased experience.
• Pouch excision decreased from 30% to 4%; intestinal obstruction remains an 18% complication.
• Crohn's disease identification is critical; sexual dysfunction in 4% of males; successful pregnancies reported.

Conclusions:

• Restorative proctocolectomy is safe and effective with decreasing complications over time.
• Careful patient selection, particularly regarding Crohn's disease and slow transit constipation, is essential.
• The procedure can be considered for distal disease causing social inconvenience and offers good outcomes in older patients.