Document Detail

Quadruple-loop (W) ileal pouch reconstruction after proctocolectomy: analysis and functional results.
MedLine Citation:
PMID:  2821639     Owner:  NLM     Status:  MEDLINE    
This report analyzes experience with a modified four-limb W-shaped ileal pouch that has a larger initial capacity than do J- or S-shaped pouch designs. Fifteen patients (median age: 35 years) underwent W pouch reconstruction after proctocolectomy for ulcerative colitis and familial adenomatous polyposis. Follow-up on each patient averaged 14 months (range: 6 to 24 months). All procedures were performed without death and with minimal morbidity. Assessment of functional results showed 24-hour stool frequency (mean +/- SEM) decreasing from 6.0 +/- 0.39 initially to 4.8 +/- 0.43 at 1 year (p less than 0.005). Night evacuation decreased from 1.1 +/- 0.2 at 1 month after surgery to 0.25 +/- 0.12 at 1 year (p less than 0.025), with 10 of 15 patients having no nocturnal pouch evacuation. Continence was excellent in all patients with the exception of three of 15 patients who had occasional minimal nighttime seepage. Pouch volume determined at surgery by saline solution infusion was 200 +/- 21 ml. Pouch volume and compliance (pressure/volume) were measured before ileostomy closure and at 6 months after surgery via a special pressure-monitored balloon catheter. Maximal pouch volume increased from 190 +/- 21 ml (at time of ileostomy takedown) to 470 +/- 85 ml at 6 months. Ileal reservoir construction with a W pouch design resulted in a low 24-hour and nighttime stool frequency and excellent compliance and evacuation characteristics.
B A Harms; J W Hamilton; D T Yamamoto; J R Starling
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Surgery     Volume:  102     ISSN:  0039-6060     ISO Abbreviation:  Surgery     Publication Date:  1987 Oct 
Date Detail:
Created Date:  1987-10-30     Completed Date:  1987-10-30     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  561-7     Citation Subset:  AIM; IM    
Division of General Surgery, University of Wisconsin-Madison.
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MeSH Terms
Adenomatous Polyposis Coli / surgery
Anal Canal / physiology
Colitis, Ulcerative / surgery*
Follow-Up Studies
Ileostomy / methods*
Ileum / physiology

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