Document Detail

Timing of restorative proctectomy following subtotal colectomy in patients with inflammatory bowel disease.
MedLine Citation:
PMID:  16630230     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: There is no general consensus regarding the timing of restorative proctocolectomy (RPC) in patients who have undergone subtotal colectomy with end ileostomy (STC). The aim of this study was to determine the impact of timing of RPC in patients who have undergone subtotal colectomy and end ileostomy for inflammatory bowel disease (IBD). METHODS: A retrospective medical record review of patients who had undergone RPC after STC was undertaken. Patients were divided into 3 groups according to timing of the completion proctectomy: <or= 3 months, 4-7 months and > 7 months. RESULTS: From 1990 to 2000, 91 patients had undergone RPC after STC for IBD. There were no statistically significant differences among the three groups relative to mean age, gender, final diagnosis, duration of disease, body mass index, comorbidity, extraintestinal manifestations, use of immunuosuppressives, or operative time. The number of intra-operative complications were significantly higher in the <or= 3 month group compared to the other groups. There was no significant difference in the overall incidence of postoperative complications among the 3 groups. Postoperative fistulas were significantly more common after RPC in Groups 1 and 2 as compared to Group 3. CONCLUSION: Restorative proctocolectomy performed within 3 months after the initial subtotal colectomy was associated with a significant increase in the incidence of intra-operative complications. Although this increase was not statistically significant, there was a significantly higher incidence of fistula formation when RPC was undertaken at up to 7 months after the subtotal colectomy for IBD. Thus, if possible, early RPC after subtotal colectomy should be discouraged.
A J Dinnewitzer; S D Wexner; M K Baig; M Oberwalder; T Pishori; E G Weiss; J Efron; J J Nogueras; A M Vernava
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland     Volume:  8     ISSN:  1462-8910     ISO Abbreviation:  Colorectal Dis     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-04-24     Completed Date:  2006-10-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883611     Medline TA:  Colorectal Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  278-82     Citation Subset:  IM    
Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida 33331, USA.
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MeSH Terms
Colitis, Ulcerative / surgery*
Colonic Pouches / adverse effects*
Follow-Up Studies
Proctocolectomy, Restorative / adverse effects*
Retrospective Studies
Time Factors
Treatment Outcome

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