| The ileo neo rectal anastomosis: long-term results of surgical innovation in patients after ulcerative colitis and familial adenomatous polyposis. | |
| | |
MedLine Citation:
|
PMID: 22885881 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
PURPOSE: Restorative proctocolectomy with ileo neo rectal anastomosis (INRA) combines cure of ulcerative colitis (UC) or familial adenomatous polyposis (FAP) with restoration of intestinal continuity. Evaluation of long-term results was needed to determine if there is a place for INRA in the armamentarium of a surgeon besides the ileal pouch anal anastomosis (IPAA). METHODS: All patients with INRA were included in the analysis. Patient demographics and clinical and follow-up data (morbidity, dietary problems, defecation frequency, fecal continence, anal and neorectal physiology, and neorectal mucosa assessment) were registered prospectively. RESULTS: Seventy-nine patients were enrolled, and in 58 patients (50 UC, 8 FAP), INRA was successful. In 21 patients, intraoperative conversion to IPAA was needed. In 49 patients with INRA, a functional reservoir was achieved. No pelvic sepsis or bladder or sexual dysfunction occurred. Thirteen patients experienced episodes of reservoir inflammation. Median bowel movements of six (5, 8) with a nocturnal defecation frequency of one were recorded with fecal continence or minor incontinence. Anal manometry and neorectal physiology showed a decrease in resting pressure and an increase in squeeze pressure and maximum tolerated volume. The median follow-up was 8.1 years (6.7, 10.1). CONCLUSIONS: This is an example of a surgical innovation with a theoretical potential to be superior to the current technique. This potential was not confirmed in short- and long-term evaluations. Hence, IPAA is currently the best available alternative to a conventional ileostomy. |
| | |
Authors:
|
Joost T Heikens; Hein G Gooszen; Johannes L J M Teepen; Willem E Hueting; Henk J Oostvogel; Theo J M V van Vroonhoven; J Han J M van Krieken; Cees J H M van Laarhoven |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2012-8-12 |
Journal Detail:
|
Title: International journal of colorectal disease Volume: - ISSN: 1432-1262 ISO Abbreviation: Int J Colorectal Dis Publication Date: 2012 Aug |
Date Detail:
|
Created Date: 2012-8-13 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8607899 Medline TA: Int J Colorectal Dis Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
|
Department of Surgery, Radboud University Nijmegen Medical Centre, Route 690, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands, j.heikens@chir.umcn.nl. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Subzero 24-hr Nonfreezing Rat Heart Preservation: A Novel Preservation Method in a Variable Magnetic...
Next Document: A randomised clinical trial (RCT) of a symbiotic mixture in patients with irritable bowel syndrome (...