The place for colectomy and ileorectal anastomosis: A valid surgical option for ulcerative colitis?

被引:37
作者
Börjesson L. [1 ]
Lundstam U. [1 ]
Öresland T. [1 ]
Brevinge H. [1 ]
Hultén L. [1 ]
机构
[1] Colorectal Unit, Department of Surgery, Sahlgrenska University Hospital/Östra, Göteborg
关键词
Function; Ileorectal anastomosis; Restorative proctocolectomy; Ulcerative colitis;
D O I
10.1007/s10151-006-0286-x
中图分类号
学科分类号
摘要
Background: Conflicting views regarding the use of ileorectal anastomosis (IRA) in ulcerative colitis (UC) exist and this controversy prompted us to review our experience, especially against the background of the current tendency to choose the ileal pouch-anal procedure (IPAA). Methods: Thirty-two consecutive patients with IRA were studied. Complications, failure rate, reasons for failure and functional results were assessed. The median follow-up time was 3.5 years. Results: The overall complication rate was 28%. The rectum was excised in 4 patients, indicating a failure rate of 12%. The mean daily evacuation frequency was 5.6. Despite urgency occurring in one-third of the patients, continence function was well preserved. Conclusions: Employed on a selective basis, IRA is a safe procedure with low mortality and morbidity and good prospects for success in many patients with UC. The patients must be prepared to submit to life-long rectoscopy surveillance.
引用
收藏
页码:237 / 241
页数:4
相关论文
共 25 条
[1]  
Aylett S.O., Diffuse ulcerative colitis and its treatment by ileo-rectal anastomosis, Dis Colon Rectum, 37, pp. 503-511, (1960)
[2]  
Aylett S.O., Three hundred cases of diffuse ulcerative colitis treated by total colectomy and ileo-rectal anastomosis, Br Med J, 1, pp. 1001-1005, (1966)
[3]  
Goligher J.C., Surgery of the Anus, Rectum and Colon, (1984)
[4]  
Albrechtsen D., Bergan A., Gjone E., Et al., Elective surgery for ulcerative colitis: Colectomy in 158 patients, Scand J Gastroenterol, 16, pp. 825-831, (1981)
[5]  
Parc R., Legrand M., Frileux P., Et al., Comparative clinical results of ileal-pouch anal anastomosis and ileorectal anastomosis in ulcerative colitis, Hepatogastroenterology, 36, pp. 235-239, (1989)
[6]  
Pastore R.L., Wolff B.G., Hodge D., Total colectomy and ileorectal anastomosis for inflammatory bowel disease, Dis Colon Rectum, 40, pp. 1455-1464, (1997)
[7]  
Okley J.R., Jagelman D.G., Fazio V., The fate rectal stump after subtotal colectomy for ulcerative colitis, Dis Colon Rectum, 28, pp. 394-396, (1985)
[8]  
Khubchandani I.T., Sandfort M.R., Rosen L., Et al., Current status of ileorectal anastomosis for inflammatory bowel disease, Dis Colon Rectum, 32, pp. 400-403, (1989)
[9]  
Leijonmarck C.E., Lofberg R., Ost A., Hellers G., Long-term results of ileorectal anastomosis in ulcerative colitis in Stockholm County, Dis Colon Rectum, 33, pp. 195-200, (1990)
[10]  
Tonelli F., Batignani G., Monaci J., Et al., Continenza e modificazioni della pressione del canale anale e della distensibilita rettale dopo ileorettoanastomosi, Chirurgia, 2, pp. 289-296, (1989)