Premium
RESULTS OF 50 ILEOANAL J POUCH OPERATIONS
Author(s) -
Curran Francis T.,
Hill Graham L.
Publication year - 1990
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1111/j.1445-2197.1990.tb07435.x
Subject(s) - medicine , pouch , pouchitis , proctocolectomy , ileostomy , ulcerative colitis , anastomosis , surgery , familial adenomatous polyposis , surgical anastomosis , general surgery , colorectal cancer , disease , cancer
Fifty ileo‐anal J pouches were constructed in 26 males and 24 females for ulcerative colitis ( n =45) and familial adenomatous polyposis ( n =5). Two‐thirds had proctocolectomy and pouch formation as a one‐stage procedure. Thirty patients had a handsewn pouch and anastomosis and 20 were stapled. Forty‐five patients had their defunctioning ileostomy closed for at least 2 months, of whom three have not been recently reviewed. One pouch was defunctioned for ischaemic stricture. The median time between pouch construction and ileostomy closure was 15 weeks and the time between closure and assessment ranged from 2 to 50 months (median 18 months). Median stool frequency was six per 24h in both the handsewn and stapled groups. Faecal incontinence occurred in 20% of patients with a handsewn anastomosis but in no patient with a stapled anastomosis ( P < 0.02). Soiling was also more common in the former group. Some 76% of patients noted an improvement in sexual activity since pouch surgery. Pouchitis has occurred in 20% of patients; 10% have had complications related to the pouch or anastomosis; 10% related to the ileostomy; and 6% have had small bowel obstruction. There have been no deaths. Overall, 88% of patients have had a good result, but none of the five patients with a poor result will revert to an ileostomy.