OUTCOME OF RESTORATIVE PROCTOCOLECTOMY WITH ILEAL RESERVOIR FOR ULCERATIVE-COLITIS - COMPARISON OF DISTAL COLITIS WITH MORE PROXIMAL DISEASE

Background-An increasing number of patients with severe or refractory ulcerative colitis involving only the rectum and sigmoid colon are bei ng offered restorative proctocolectomy with ileal reservoir but very f ew data are available concerning the outcome for these patients. Aim-T his study was designed to compare the outcome of ileal pouch procedure s for distal ulcerative colitis with procedures performed for more ext ensive disease. Patients-A consecutive series of 177 patients undergoi ng restorative proctocolectomy for ulcerative colitis between January 1984 and December 1994. Methods-Data were collected prospectively in a dedicated ileal pouch database and included demographic details, indi cation for surgery, surgical procedures performed, early (<30 days) an d late morbidity, functional outcome, and histopathology. Results-Ther e was no mortality in the series. The incidence and range of early mor bidity (<30 days) and the functional outcome (daytime stool frequency, nocturnal frequency, and the incidence of incontinence) were similar for all groups. Log rank analysis of Kaplan-Meier estimates showed no significant difference between groups in the likelihood of developing pouchitis (p>0.2). Conclusions-Patients undergoing restorative proctoc olectomy for distal colitis experience a similar outcome to patients w ith more extensive disease. These data refute the hypothesis that pouc hitis is more common in patients with total colitis.