Clinical Results of One-stage Restorative Proctocolectomy with J-pouch Anal Anastomosis in 300 Ulcerative Colitis Patients
Objectives: Restorative proctocolectomy and ileal pouch anal anastomosis (IPAA), with diverting ileostomy, are established ulcerative colitis (UC) treatments. The routine use of diverting ileostomy is controversial because of the risk of stoma closure and stoma related complications. In our institut...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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The Japan Society of Coloproctology
2020-10-01
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| Series: | Journal of the Anus, Rectum and Colon |
| Subjects: | |
| Online Access: | https://www.jstage.jst.go.jp/article/jarc/4/4/4_2020-003/_pdf/-char/en |
| _version_ | 1818531812163452928 |
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| author | Ryuichi Kuwahara Hiroki Ikeuchi Toshihiro Bando Hirohumi Sasaki Yoshiko Goto Yuki Horio Tomohiro Minagawa Motoi Uchino |
| author_facet | Ryuichi Kuwahara Hiroki Ikeuchi Toshihiro Bando Hirohumi Sasaki Yoshiko Goto Yuki Horio Tomohiro Minagawa Motoi Uchino |
| author_sort | Ryuichi Kuwahara |
| collection | DOAJ |
| description | Objectives: Restorative proctocolectomy and ileal pouch anal anastomosis (IPAA), with diverting ileostomy, are established ulcerative colitis (UC) treatments. The routine use of diverting ileostomy is controversial because of the risk of stoma closure and stoma related complications. In our institution, proctocolectomy and IPAA, with mucosectomy and handsewn anastomosis without diversion (one-stage IPAA), were performed for select patients with UC. The present study aimed to evaluate the clinical and functional outcomes of patients undergoing one-stage IPAA.
Methods: Between April 1999 and July 2017, 300 patients underwent one-stage IPAA in our institution. The clinical notes and prognosis were reviewed retrospectively.
Results: Postoperative complications (Clavien-Dindo classification grade III) occurred in 18 patients (6.0%). The most common complication was anastomotic leakage (n = 9, 3%). There were 15 patients (5.0%) who required a defunctioning ileostomy. However, 13 patients successfully underwent ileostomy closure and achieved acceptable pouch function. Finally, two patients (0.6%) required pouch excision in this series. The cumulative pouch functional rate was 99.6% / 5 years and 99.2% / 10 years.
Conclusions: One-stage IPAA is a good strategy for carefully selected patients with UC. |
| first_indexed | 2024-12-11T17:37:20Z |
| format | Article |
| id | doaj.art-37e253ed1fdc4dd284df492d38b427a9 |
| institution | Directory Open Access Journal |
| issn | 2432-3853 |
| language | English |
| last_indexed | 2024-12-11T17:37:20Z |
| publishDate | 2020-10-01 |
| publisher | The Japan Society of Coloproctology |
| record_format | Article |
| series | Journal of the Anus, Rectum and Colon |
| spelling | doaj.art-37e253ed1fdc4dd284df492d38b427a92022-12-22T00:56:37ZengThe Japan Society of ColoproctologyJournal of the Anus, Rectum and Colon2432-38532020-10-014418118510.23922/jarc.2020-0032020-003Clinical Results of One-stage Restorative Proctocolectomy with J-pouch Anal Anastomosis in 300 Ulcerative Colitis PatientsRyuichi Kuwahara0Hiroki Ikeuchi1Toshihiro Bando2Hirohumi Sasaki3Yoshiko Goto4Yuki Horio5Tomohiro Minagawa6Motoi Uchino7Department of Gastroenterology, Division of Inflammatory Bowel Disease, Hyogo College of MedicineDepartment of Gastroenterology, Division of Inflammatory Bowel Disease, Hyogo College of MedicineDepartment of Gastroenterology, Division of Inflammatory Bowel Disease, Hyogo College of MedicineDepartment of Gastroenterology, Division of Inflammatory Bowel Disease, Hyogo College of MedicineDepartment of Gastroenterology, Division of Inflammatory Bowel Disease, Hyogo College of MedicineDepartment of Gastroenterology, Division of Inflammatory Bowel Disease, Hyogo College of MedicineDepartment of Gastroenterology, Division of Inflammatory Bowel Disease, Hyogo College of MedicineDepartment of Gastroenterology, Division of Inflammatory Bowel Disease, Hyogo College of MedicineObjectives: Restorative proctocolectomy and ileal pouch anal anastomosis (IPAA), with diverting ileostomy, are established ulcerative colitis (UC) treatments. The routine use of diverting ileostomy is controversial because of the risk of stoma closure and stoma related complications. In our institution, proctocolectomy and IPAA, with mucosectomy and handsewn anastomosis without diversion (one-stage IPAA), were performed for select patients with UC. The present study aimed to evaluate the clinical and functional outcomes of patients undergoing one-stage IPAA. Methods: Between April 1999 and July 2017, 300 patients underwent one-stage IPAA in our institution. The clinical notes and prognosis were reviewed retrospectively. Results: Postoperative complications (Clavien-Dindo classification grade III) occurred in 18 patients (6.0%). The most common complication was anastomotic leakage (n = 9, 3%). There were 15 patients (5.0%) who required a defunctioning ileostomy. However, 13 patients successfully underwent ileostomy closure and achieved acceptable pouch function. Finally, two patients (0.6%) required pouch excision in this series. The cumulative pouch functional rate was 99.6% / 5 years and 99.2% / 10 years. Conclusions: One-stage IPAA is a good strategy for carefully selected patients with UC.https://www.jstage.jst.go.jp/article/jarc/4/4/4_2020-003/_pdf/-char/enulcerative colitisrestorative proctocolectomywithout diverting ileostomy |
| spellingShingle | Ryuichi Kuwahara Hiroki Ikeuchi Toshihiro Bando Hirohumi Sasaki Yoshiko Goto Yuki Horio Tomohiro Minagawa Motoi Uchino Clinical Results of One-stage Restorative Proctocolectomy with J-pouch Anal Anastomosis in 300 Ulcerative Colitis Patients Journal of the Anus, Rectum and Colon ulcerative colitis restorative proctocolectomy without diverting ileostomy |
| title | Clinical Results of One-stage Restorative Proctocolectomy with J-pouch Anal Anastomosis in 300 Ulcerative Colitis Patients |
| title_full | Clinical Results of One-stage Restorative Proctocolectomy with J-pouch Anal Anastomosis in 300 Ulcerative Colitis Patients |
| title_fullStr | Clinical Results of One-stage Restorative Proctocolectomy with J-pouch Anal Anastomosis in 300 Ulcerative Colitis Patients |
| title_full_unstemmed | Clinical Results of One-stage Restorative Proctocolectomy with J-pouch Anal Anastomosis in 300 Ulcerative Colitis Patients |
| title_short | Clinical Results of One-stage Restorative Proctocolectomy with J-pouch Anal Anastomosis in 300 Ulcerative Colitis Patients |
| title_sort | clinical results of one stage restorative proctocolectomy with j pouch anal anastomosis in 300 ulcerative colitis patients |
| topic | ulcerative colitis restorative proctocolectomy without diverting ileostomy |
| url | https://www.jstage.jst.go.jp/article/jarc/4/4/4_2020-003/_pdf/-char/en |
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