Clinical and functional outcome after restorative proctocolectomy.
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 func...
| Main Authors: | , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
1991
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| _version_ | 1797054215905869824 |
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| author | de Silva, H de Angelis, C Soper, N Kettlewell, MG Mortensen, N Jewell, D |
| author_facet | de Silva, H de Angelis, C Soper, N Kettlewell, MG Mortensen, N Jewell, D |
| author_sort | de Silva, H |
| collection | OXFORD |
| description | 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. |
| first_indexed | 2024-03-06T18:54:03Z |
| format | Journal article |
| id | oxford-uuid:1136e8d2-970e-4111-a2be-9b22aed2e7d8 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T18:54:03Z |
| publishDate | 1991 |
| record_format | dspace |
| spelling | oxford-uuid:1136e8d2-970e-4111-a2be-9b22aed2e7d82022-03-26T10:01:03ZClinical and functional outcome after restorative proctocolectomy.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:1136e8d2-970e-4111-a2be-9b22aed2e7d8EnglishSymplectic Elements at Oxford1991de Silva, Hde Angelis, CSoper, NKettlewell, MGMortensen, NJewell, DRestorative 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. |
| spellingShingle | de Silva, H de Angelis, C Soper, N Kettlewell, MG Mortensen, N Jewell, D Clinical and functional outcome after restorative proctocolectomy. |
| title | Clinical and functional outcome after restorative proctocolectomy. |
| title_full | Clinical and functional outcome after restorative proctocolectomy. |
| title_fullStr | Clinical and functional outcome after restorative proctocolectomy. |
| title_full_unstemmed | Clinical and functional outcome after restorative proctocolectomy. |
| title_short | Clinical and functional outcome after restorative proctocolectomy. |
| title_sort | clinical and functional outcome after restorative proctocolectomy |
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