Document Detail


Longterm appraisal of the histological appearances of the ileal reservoir mucosa after restorative proctocolectomy for ulcerative colitis.
MedLine Citation:
PMID:  7829009     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Between November 1976 and December 1985, 110 patients had restorative proctocolectomy for ulcerative colitis. The histological appearances in the reservoir mucosa were followed up in 60 of 109 survivors over 19-173 months (median 97). The median number of biopsy specimens taken per patient was six with a range of 3-13. These were examined by one pathologist (ICT) unaware of the clinical details using a scoring system previously described to assess the degree of chronic and acute inflammation. There was a significant correlation between the degree of severity of chronic and acute changes (r = 0.6192, p < 0.000001). There was no correlation between the severity of inflammation and the following variables: preoperative duration of disease, presence of cancer or dysplasia in the original operative specimen, extra-alimentary manifestations or the type of reservoir. A significant correlation between severe inflammation and male sex was found (p < 0.035). The 60 patients could be divided into three groups based on the severity and fluctuation of histological inflammation. In group A (n = 27, 45%) chronic changes were minor and acute inflammation was never seen. In group B (n = 25, 42%) chronic changes were more severe and there were transient episodes of acute inflammation. In group C (n = 8, 13%) severe chronic and severe acute inflammation were constantly present. Differentiation of the three groups had clearly occurred within six months from closure of the ileostomy. Patients in group C could be identified on histological criteria within weeks of closure of the ileostomy and were those exclusively at risk of developing chronic pouchitis. Chronic pouchitis never occurred in patients of groups A and B. No case of dysplasia was seen. Histological assessment of the reservoir mucosa with in a few months after closure of the ileostomy seems to define patients who will and who will not subsequently develop pouchitis.
Authors:
P Setti Carraro; I C Talbot; R J Nicholls
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Gut     Volume:  35     ISSN:  0017-5749     ISO Abbreviation:  Gut     Publication Date:  1994 Dec 
Date Detail:
Created Date:  1995-02-21     Completed Date:  1995-02-21     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  2985108R     Medline TA:  Gut     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  1721-7     Citation Subset:  AIM; IM    
Affiliation:
St Mark's Hospital, London.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Colitis, Ulcerative / pathology,  surgery*
Female
Fibrosis / pathology
Granuloma / pathology
Humans
Ileitis / pathology
Ileum / pathology*
Intestinal Mucosa / pathology
Male
Middle Aged
Postoperative Complications
Proctocolectomy, Restorative*
Prognosis
Sex Factors
Time Factors
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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