[Total proctocolectomy with an ileoanal anastomosis and reservoir]

The following report documents the initial experience (13 cases) and the one year functional and quality of life results after restorative proctocolectomy procedures in the Surgery Clinic of Fundeni Hospital. The histologic preoperative diagnosis was ulcerative colitis in 7 patients (53.84%) and familial polyposis in 6 patients (46.16%). 80% of patients experienced at least one postoperative complication after pouch construction or ileostomy closure. There was a single death in our patient group. This occurred in a patient with malignized polyposis, who died in the first 24 hours after operation from bilateral pulmonary emboli. The necropsy exam has shown also a metastatic nodule of the liver. The most frequent complication in our series was the small bowel obstruction and the pouch-anal anastomosis leak (30.76%). Patients' follow-up was achieved by means of a questionnaire which assessed pouch function at follow-up visit at 1 month, 3 month, 6 month and one year after the ileostomy closure. Quality of life was also assessed by that questionnaire and included injury into aspects of occupational, social and sexual function. The functional and quality of life results in this series was very similar to that reported by other authors who have performed restorative proctocolectomy for ulcerative colitis and familial polyposis.