J. Tiainen et al., Eleven years' experience of postoperative morbidity and trends in handsewnileo-anal anastomosis with pelvic J-pouch for ulcerative colitis, ANN CHIR GY, 88(2), 1999, pp. 118-121
Background and Aims: Restorative proctocolectomy with mucosectomy and hands
ewn J-pouch-anal anastomosis is the curative operation of choice for ulcera
tive colitis.
The aim of this study was to determine frequencies of various complications
at perioperative time (within 30 days after surgery) with this operative m
ethod. We also evaluated the chances of failure of this restorative operati
on and the trends in operative management.
Material and Methods: Evaluation was based on a register containing data on
all patients operated for ulcerative colitis at our department since the b
eginning of 1985. Statistical analysis was made for all adult patients (ove
r 18 years) who underwent an operation for ulcerative colitis during the 11
years' time period.
Results: A total of 170 adult patients underwent an elective operation for
ulcerative colitis between March 1985 and December 1995. In 154 cases a res
torative procedure was intended. In 142 (92 %) cases this proved possible,
and in 136 of these a handsewn J-pouch-anal anastomosis was created. The ch
ance of failure in the restorative operation was higher in men (p = 0.0314)
.
During the latter five years' period IAA operations were performed more oft
en as a second-stage procedure.
Uneventful recovery was reported in 62 (45.5 %) cases. One or more complica
tions were encountered in 74 (55.1 %) patients.
Corticosteroid treatment did not affect leakage frequency.
In spite of the high morbidity there were no perioperative deaths.