RESTORATIVE PROCTOCOLECTOMY IN ONE-STAGE - BENEFITS AND RISK-FACTORS

A collective experience of restorative proctocolectomy with << J >> po uch over seven and a half years is presented comparing 63 patients wit h covering ileostomy and 122 patients with no ileostomy. There was no postoperative mortality in either group, and permanent failure resulte d in four (6.3 %) and one (0.8 %) of patients with and without coverin g ileostomy, respectively. Total number of postoperative complications was slightly more in the ileostomy group (38 vs. 30 %), and significa nt ileostomy related complications or anastomosis leakage were more co mmon in patients with covering ileostomy (24 %) than anastomosis leaka ge needing later covering ileostomy in the no ileostomy group (14 %). There was a median saving of 12 hospital days and 30 sick-leave days i n favor of no ileostomy. Severe active ulcerative colitis and male sex (indicating technically difficult anastomosis) emerged as significant risk factors of anastomosis leakage in the no ileostomy group, while steroid use as such seemed not to be a special risk. It was concluded that one stage restorative proctocolectomy suits well for most patient s in good general condition when a technically sound anastomosis witho ut tension can be done.