Effect of anorectal eversion on long-term clinical outcome of restorative proctocolectomy.

Autor: DeFriend DJ; Department of Surgery, University Hospital of South Manchester, Chorley Hospital, Lancs, England., Mughal M, Grace RH, Schofield PF
Jazyk: angličtina
Zdroj: Journal of the Royal Society of Medicine [J R Soc Med] 1997 Jul; Vol. 90 (7), pp. 375-8.
DOI: 10.1177/014107689709000705
Abstrakt: Eversion of the rectum during restorative proctocolectomy with stapled ileal pouch-anal anastomosis (IPAA) remains a controversial surgical manoeuvre because of concern that it may impair anal sphincter function and adversely affect outcome. We have reviewed the long-term results in 41 patients whose operation included formation of a 20 cm J-pouch with stapled IPAA by the technique of rectal eversion. At median follow-up of 4 years (range 1-6 years), 4 pouches (10%) had been removed (2 for pelvic sepsis, 1 for rectovaginal fistula and 1 for Crohn's disease). In 34 patients with functioning pouches in situ, median stool frequency was 5 per 24 h (range 2-10). 11 patients (33%) regularly had to evacuate their pouch at night and 4 (12%) used antidiarrhoeal medication. No patients reported major incontinence; 2 (6%) had minor leakage, and in another 2 minor leakage had now ceased. 4 patients had had episodes of pouchitis. These favourable results offer no support for the contention that rectal eversion substantially worsens the long-term results of restorative proctocolectomy.
Databáze: MEDLINE