Jg. Armengol et al., EVOLUTIVE STUDY OF THE FUNCTIONAL RESULTS AFTER RESTORATIVE PROCTOCOLECTOMY FOR ULCERATIVE-COLITIS, Revista espanola de enfermedades digestivas, 89(9), 1997, pp. 692-698
Aim: evolutive study of the functional results after restorative proct
ocolectomy for ulcerative colitis. Patients and methods: prospective s
tudy in 24 patients with an ileoanal ''J'' pouch (n = 8: mucosectomy a
nd hand-sewn anastomosis; n 16: stapled anastomosis without mucosectom
y). A clinical survey was carried out during two evolutive follow-ups
of the functional pouch (medians: 14.5 and 39.0 months) as well as an
anorectal manometry study during the preoperative period and in two fo
llow-ups after the creation of the pouch (medians: 6.0 and 35.5 months
). Results: the mean frequency of defecation per 24 hours and per nigh
t teas significantly reduced in the first follow-up (5.5 [24 h]; p < 0
.003 and 1.0 [per night]; p < 0.009) compared with the postoperative p
eriod (7.9 [24 h] and 1.4 [per night]), with no significant changes in
the second follow-up (5.5 [24 h] and 0.9 [per night]), At the same ti
me, it has been significantly lower in patients with stapled anastomos
is in the different evolutive follow-ups, One patient (4.2%) had major
fecal incontinence in the two evolutive follow-ups and 7 (29.2%) and
6 (25%) patients had minor incontinence in the first and second follow
-up respectively, The mean maximum resting anal pressure in the first
follow-up was significantly lower (p = 0.002) in patients with mucosec
tomy than the values observed in patients with stapled anastomosis (35
.4 vs 68.0 mmHg). In the second follow-up increased significantly (p =
0.046) only in patients with mucosectomy (55.1 mmHg). Recto-anal inhi
bitory reflex was present in 2 (10%) and 9 (45%) patients in the first
and second follow-up respectively. Conclusions: the functional result
s improve significantly with the follow-up time, fundamentally during
the first year of the functional pouch.