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Title: | Clinical and functional outcome after restorative proctocolectomy |
Authors: | de Silva, H.J. de Angelis, C.P. Soper, N. Kettlewell, M.G. Mortensen, N.J. Jewell, D.P. |
Keywords: | Ileitis-etiology Ileitis-physiopathology Ileitis-radionuclide imaging Ileum-physiopathology Ileum-radionuclide imaging Anal Canal-physiopathology Anal Canal-radionuclide imaging Anastomosis, Surgical Colonic Diseases-surgery Postoperative Complications-physiopathology Proctocolectomy, Restorative-methods Clinical Trial Controlled Clinical Trial |
Issue Date: | 1991 |
Citation: | British Journal of Surgery. 1991; 78(9): pp.1039-44 |
Abstract: | Restorative proctocolectomy and ileal pouch-anal anastomosis (IPAA) has been carried out on 88 patients since 1982. Three different pouch designs (J, S and W) were used. Ten pouches had to be removed. Detailed analysis was performed on 61 patients (J = 23, S = 15, W = 23) whose pouches had been functioning for at least 6 months. There was no significant difference in surgical complications before or after ileostomy closure between pouch designs but the hospital stay was greater after construction of an S pouch (P less than 0.05). There were no significant differences in stool frequency, degree of continence or urgency between the three types. Twelve patients with J pouches required antidiarrhoeal medication compared with only one with S and five with W pouches. Only seven patients with S pouches could defaecate spontaneously compared with 22 with W pouches and all patients with J pouches (P less than 0.001). Twenty-five of 29 patients who had preservation of the anal transition zone had perfect continence compared with 23 of 32 with a mucosal proctectomy (P = n.s.). Pouchitis occurred in 13 patients, all of whom had ulcerative colitis. In a subgroup of 23 patients, pouch evacuation was assessed scintigraphically. There was no difference in pouch capacity or total volume evacuated, but spontaneous evacuation was better in J and W pouches compared with S pouches |
Description: | Indexed in MEDLINE |
URI: | http://repository.kln.ac.lk/handle/123456789/1141 |
ISSN: | 0007-1323 (Print) 1365-2168 (Electronic) |
Appears in Collections: | Journal/Magazine Articles |
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