THE FIRST 10 YEARS EXPERIENCE OF RESTORATIVE PROCTOCOLECTOMY FOR ULCERATIVE-COLITIS

Between 1976 and 1985, 110 patients had restorative proctocolectomy or proctectomy for ulcerative colitis and 103 were followed up until dea th or February 1992. There was one postoperative and one late death re lated to surgery. The cumulative probability of pouch failure was 12% at five years: half of the failures occurred within one year. The comm onest reasons were perianal/pelvic sepsis and probable Crohn's disease . The cumulative probability of readmission, excluding that for ileost omy closure, was 68% at five years. There were 152 operations carried out during readmissions. These included 44 laparotomies. Function was assessed in 80 patients at a mean of 99.3 months after ileostomy closu re. For 66 patients with spontaneous evacuation, average minimum diurn al frequency was 3.8, maximum 4.9, with 35 evacuating at night. One pa tient experienced major continence problems, 30 had minor leaks, and 4 9 were completely continent. Postoperatively, five patients gave birth to nine babies, four had renal stones, two myasthenia gravis, and two severe anaemia: seven had pre or postoperative thyroid dysfunction.