Proctocolectomy with ileal reservoir and anal anastomosis

✍ Scribed by A. G. Parks; R. J. Nicholls; P. Belliveau

• Publisher: John Wiley and Sons
• Year: 1980
• Tongue: English
• Weight: 619 KB
• Volume: 67
• Category: Article
• ISSN: 0007-1323
• DOI: 10.1002/bjs.1800670802

✦ Synopsis

Summary

A technique of proctocolectomy avoiding an ileostomy has been developed for patients with ulcerative colitis or polyposis coli. After excision of all diseased tissue a reservoir of terminal ileum is constructed which is brought through the rectal stump denuded of mucosa; an ileo-anal anastomosis is then carried out.

Twenty-one patients (17 ulcerative colitis, 4 polyposis) have been treated and 20 followed for from 2 to 34 months (mean 13·5 months). There was no mortality but early complications occurred in 9 patients. All are currently well, with no disturbance of urinary or sexual function. Continence of faeces is complete in all during the day, but 1 patient evacuates unconsciously at night. The average frequency of evacuation is 3·8 times in 24 h. Ten patients void spontaneously. All patients tolerate a full diet and only 2 use medicaments to reduce frequency.

This operation appears to be a satisfactory alternative to proctocolectomy with a permanent ileostomy.