LONG-TERM RESULTS OF RESTORATIVE PROCTOCOLECTOMY FOR ULCERATIVE-COLITIS

To study the long-term effects of restorative proctocolectomy with J-p ouch for ulcerative colitis 100 consecutive patients were examined a m ean of 5.6 years after ileal pouch-anal anastomosis (IPAA). Seventy-th ree percent of patients were on steroids and 22% had a preceding sever e attack of colitis before IPAA. The overall early and late complicati on rates were 40% and 33%, respectively. Failure rate was 5% and all f ailures requiring pouch excision occurred within the first three posto perative years. Pouchitis (36%) was the commonest late complication. A preceding severe attack of colitis was an important prognostic sign o f late anastomotic complications, troublesome incontinence and ultimat e failure. The daily mean stool frequency varied from 4.5 to 6.9. Afte r a short learning period continence - stabilised and minor incontinen ce was common (57%). The majority of patients (72%) were either very s atisfied or had no problems in daily activities after IPAA. Ten patien ts were dissatisfied after surgery due to obvious medical reasons in m ost of them.