Document Detail

Surgery for ulcerative colitis in 1,000 patients.
MedLine Citation:
PMID:  20217422     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND AIMS: Ileal pouch-anal anastomosis (IPAA) has become the standard treatment for patients with ulcerative colitis (UC) who ultimately require a colectomy. Herein, we report results of our 24-year experience with that surgical method at our hospital. PATIENTS AND METHODS: Data were collected regarding surgical procedures and postoperative pathologic diagnoses for 1,000 UC patients, with early and late complications also noted. The pouch functioning rate was calculated using the Kaplan-Meier method. RESULTS: We performed 1,000 operations for UC over a 24-year period. The mean patient age at the time of operation was 35 years, and the most frequent indication for a colectomy was intractable disease. The overall rates of pouch success after 10 and 20 years were 97% and 89%, respectively. During the study period, 944 patients underwent IPAA at our hospital, of whom 12 (1.3%) were eventually diagnosed with Crohn's disease (CD). Pouch success was higher in patients with UC, with a functioning ileal pouch after 10 and 20 years found in 97% and 92%, respectfully, whereas the proportions of patients with CD and a functioning ileal pouch were lower at 82% and 20%, respectively (p < 0.01). CONCLUSION: A restorative proctocolectomy with an IPAA is a safe procedure, with low rates of mortality and major morbidity. We do not recommend routine application of IPAA in any subset of patients with known CD.
Hiroki Ikeuchi; Motoi Uchino; Hiroki Matsuoka; Toshihiro Bando; Takayuki Matsumoto; Naohiro Tomita; Yasutugu Syoji; Masato Kusunoki; Takehira Yamamura; Joji Utsunomiya
Publication Detail:
Type:  Journal Article     Date:  2010-03-09
Journal Detail:
Title:  International journal of colorectal disease     Volume:  25     ISSN:  1432-1262     ISO Abbreviation:  Int J Colorectal Dis     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-06-23     Completed Date:  2010-09-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8607899     Medline TA:  Int J Colorectal Dis     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  959-65     Citation Subset:  IM    
Department of Surgery, Hyogo College of Medicine, Hyogo, Japan.
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MeSH Terms
Aged, 80 and over
Anastomosis, Surgical / statistics & numerical data*
Cause of Death
Colitis, Ulcerative / physiopathology,  surgery*
Colonic Pouches / pathology,  statistics & numerical data*
Middle Aged
Postoperative Complications / etiology
Surgical Procedures, Elective / statistics & numerical data
Time Factors
Treatment Outcome
Young Adult

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