[Results of ileoanal reservoir surgery]

Area of Science:

• Gastroenterology
• Surgical Oncology
• Colorectal Surgery

Context:

• 157 consecutive restorative proctocolectomies with ileoanal J pouch performed.
• Patients treated for ulcerative colitis (148) and familial adenomatous polyposis (9).
• All patients initially received a protecting ileostomy.

Purpose:

• To report surgical, late complications, and functional outcomes.
• Evaluate the safety and efficacy of the ileoanal J pouch procedure.
• Assess patient satisfaction and functional results one year post-surgery.

Summary:

• No mortality observed. Early surgical complications included bleeding and ileus, with one pelvic abscess. Late complications involved pouch removal for incontinence, evacuation difficulties, pouchitis, or Crohn's disease, and three late pouchovaginal fistulae.
• Post-ileostomy closure, reoperations were mainly for wound infections and ileus. Late complications also included incisional hernias and fistulas.
• Over 90% of patients were satisfied one year after surgery. Functional outcomes were generally satisfactory, though 21.1% reported night evacuations and 13.9% experienced incontinence.

Impact:

• The ileoanal J pouch is a viable option for restorative proctocolectomy with acceptable complication rates and high patient satisfaction.
• Understanding late complications is crucial for long-term patient management and counseling.
• This study provides valuable data on functional outcomes, aiding in surgical decision-making for ulcerative colitis and FAP patients.