Anastomosis ileorrectal en el tratamiento quirúrgico de la colitis ulcerosa: Resultados a largo plazo
| Autor: | Álvaro Zúñiga D, Pablo Wagner H, Felipe Bellolio R, Ignacio Duarte G, José M Zúñiga A, George Pinedo M |
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| Rok vydání: | 2008 |
| Předmět: | |
| Zdroj: | Revista médica de Chile v.136 n.9 2008 SciELO Chile CONICYT Chile instacron:CONICYT |
| ISSN: | 0034-9887 |
| Popis: | Background: Total colectomy with ileorectal anastomosis (IRA) is an alternative to the ileoanal pouch for the surgical treatment of ulcerative colitis in a selected group of patients. This technique leaves rectal mucosa liable to develop persistent proctitis, dysplasia and cancer. Aim: To describe short and long-term results of IRA and to assess the presence of dysplasia. Material and methods: Descriptive study of patients treated with IRA. The data were obtained from the clinical records, and the present status was evaluated with an interview. A proctoscopy and biopsy was offered free of cost to the contacted patients. Results: Between 1978 and 2005, 26 patients were operated. One patient presented an anastomotic leakage that was treated with a loop ileostomy. There was no operative mortality. Twenty-three patients were followed for a period of 1 to 23 years. Three patients evolved as Crohn’s disease and two of them needed a proctectomy. Three patients died of non-related diseases. In the remaining 17, the average evacuation rate was 3.7/24 h and all were continent. None developed a rectal cancer. Only two patients had their planned annual endoscopic surveillance. In 2 of the 11 patients who accepted endoscopy and biopsy, a low-grade dysplasia was found. Conclusions: IRA has low morbidity and acceptable functional results in this selected group of patients. No patient present high-grade dysplasia or cancer; however, the adherence to the endoscopic follow-up is poor (Rev Med Chile 2008; 136: 1121-6). (Key words: Colitis, ulcerative; Endoscopy, digestive system; Rectal neoplasms) |
| Databáze: | OpenAIRE |
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