Document Detail

Clinico-pathological follow-up after total colectomy and straight ileo-anal anastomosis done for ulcerative colitis.
MedLine Citation:
PMID:  11990329     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Restorative proctocolectomy is used as surgical treatment for ulcerative colitis. We have earlier documented adaptative changes in the terminal ileum after total colectomy, and straight ileo-anal anastomosis. AIM: To correlate the morphologic and functional changes in the ileal mucosa after total colectomy and hand-sewn straight ileo-anal anastomosis for ulcerative colitis. METHODS: Thirty consecutive patients (age range 15-50 years, 24 men) who had undergone total colectomy, rectal mucosectomy and hand-sewn straight ileo-anal anastomosis for ulcerative colitis were included in the study. These patients were followed up at 3-monthly intervals following surgery for two years and later once every year for a median duration of 9.5 (range 1-17) years. The clinical parameters studied were weight gain, frequency of stools, nature of stools, nocturnal stool frequency and need for antidiarrheal drugs. At each follow-up visit they were subjected to per rectal ileoscopy with ileal biopsy and barium enema. Ileal biopsy was analyzed histologically and histochemically. RESULTS: The clinical features improved over time, with average weight gain of 5 (range 1-7) Kg at one year. Frequency of stools decreased from 8-10 per day to 2-3 per day. The stools became semisolid and there was no need for antidiarrheal drug by the end of one year. All the patients showed adaptative changes in the ileum. The ileal mucosa was completely transformed into colonic type by the end of one year, colonoscopically (spacious lumen characteristic of colon), radiologically (disappearance of ileal characteristics with rectosigmoid-like appearance), histologically (blunting of villi with increase in goblet cells), and histochemically (sialomucin pattern to sulfomucin pattern). CONCLUSIONS: The ileum undergoes adaptative changes with corresponding improvement of clinical parameters over time, after proctocolectomy and ileoanal anastomosis for ulcerative colitis.
R D Bapat; G D Bakhshi; C V Kantharia; A P Iyer; A S Joshi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology     Volume:  21     ISSN:  0254-8860     ISO Abbreviation:  Indian J Gastroenterol     Publication Date:    2002 Mar-Apr
Date Detail:
Created Date:  2002-05-06     Completed Date:  2002-05-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8409436     Medline TA:  Indian J Gastroenterol     Country:  India    
Other Details:
Languages:  eng     Pagination:  64-6     Citation Subset:  IM    
Department of General Surgery, Seth G S Medical College and K E M Hospital, Mumbai.
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MeSH Terms
Colitis, Ulcerative / pathology,  surgery*
Follow-Up Studies
Ileum / pathology
Intestinal Mucosa / pathology
Proctocolectomy, Restorative*
Time Factors

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