Restorative proctocolectomy with ileal reservoir for ulcerative colitis and familial adenomatous polyposis: A comparison of three reservoir designs

1985 ◽  
Vol 72 (6) ◽  
pp. 470-474 ◽  
Author(s):  
R. J. Nicholls ◽  
M. E. Pezim
Keyword(s):  
Ulcerative Colitis ◽  
Familial Adenomatous Polyposis ◽  
Restorative Proctocolectomy ◽  
Ileal Reservoir ◽  
Adenomatous Polyposis

scholarly journals Restorative Proctocolectomy: When to Propose and When to Avoid

2021 ◽  
Author(s):  
Marisa D. Santos
Keyword(s):  
Ulcerative Colitis ◽  
Familial Adenomatous Polyposis ◽  
Restorative Proctocolectomy ◽  
Ileal Pouch ◽  
Adenomatous Polyposis ◽  
Entire Colon ◽  
Anal Anastomosis ◽  
Colon And Rectum ◽  
Complex Surgery ◽  
Over Time

Restorative proctocolectomy with ileal pouch-anal anastomosis (RPC-IPAA) is a surgical procedure performed when excising the entire colon and rectum is need and reconstitution of the intestinal transit through an ileal pouch is made with anastomosis to the anus. It is mainly used to treat patients with familial adenomatous polyposis (FAP) and ulcerative colitis (UC). It is a complex surgery with potential complications, and the functional outcomes can be worse over time. So, it is essential to select the appropriate patient, proceed to a correct surgical technique, and know-how to deal with and solve the main ileal pouch complications. This chapter intends to be a reflection on this subject.

scholarly journals Salvage surgery after restorative proctocolectomy

2004 ◽  
Vol 51 (2) ◽  
pp. 23-26
Author(s):  
R.J. Nicholls
Keyword(s):  
Ulcerative Colitis ◽  
Familial Adenomatous Polyposis ◽  
Restorative Proctocolectomy ◽  
Salvage Surgery ◽  
Rectal Mucosa ◽  
Neoplastic Transformation ◽  
Mucosal Inflammation ◽  
Adenomatous Polyposis ◽  
Elective Surgical Procedure ◽  
Causes Of Failure

Restorative proctocolectomy is now the elective surgical procedure of choice for most patients with ulcerative colitis or familial adenomatous polyposis. There are four causes of failure including acute and chronic sepsis, poor function for mechanical or functional reasons, mucosal inflammation (including pouchitis and retained rectal mucosa) and neoplastic transformation. Failure rates themselves range from 5% to nearly 20%. Followed over a period of 20 years, the failure rate can be summarised approximately as 5% at five years, 10% at ten years and 15% at 15 years.

Restorative Proctocolectomy in UK Servicemen

2001 ◽  
Vol 87 (3) ◽  
pp. 154-157
Author(s):  
R J Guy ◽  
S Blake ◽  
N P J Cripps
Keyword(s):  
Ulcerative Colitis ◽  
Familial Adenomatous Polyposis ◽  
Service Life ◽  
Restorative Proctocolectomy ◽  
Telephone Interview ◽  
Adenomatous Polyposis ◽  
Royal Navy ◽  
Pouch Function ◽  
Medical Category

AbstractObjectiveTo investigate the outcome of restorative proctocolectomy (RPC) in UK Servicemen and to determine the compatibility of this procedure with Service life.PatientsAll Servicemen undergoing restorative proctocolectomy for ulcerative colitis (UC) or familial adenomatous polyposis (FAP) up to December 31st 2000 were identified from Service records. Patients were reviewed by direct or telephone interview. Pouch function, military duties, medical category or reasons for discharge from the Service were recorded. Results: Fifteen Servicemen (6 Royal Navy, 6 Army, 3 RAF), mean age 30 years, underwent RPC for UC (14) or FAP (1) with a median follow-up of 74 months. Eight remain in their Service, five of whom carry out full duties and three restricted duties. Of the seven who have left the Services only one was medically unfit to continue due to poor pouch function whilst six left voluntarily to pursue active civilian careers. Fourteen patients have acceptable pouch function; one pouch has been excised for intractable pouchitis.ConclusionsRestorative proctocolectomy is compatible with Service life and most individuals are capable of fulfilling active unrestricted military duties.

scholarly journals Surgical treatment of familial adenomatous polyposis: ileoretal anastomosis or restorative proctolectomy?

2009 ◽  
Vol 46 (4) ◽  
pp. 294-299 ◽  
Author(s):  
Fábio Guilherme Campos ◽  
Rodrigo Oliva Perez ◽  
Antônio Rocco Imperiale ◽  
Víctor Edmond Seid ◽  
Sérgio Carlos Nahas ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Familial Adenomatous Polyposis ◽  
Restorative Proctocolectomy ◽  
Ileorectal Anastomosis ◽  
Cumulative Risk ◽  
Oncological Outcome ◽  
Ileal Reservoir ◽  
Adenomatous Polyposis ◽  
Operative Complications

CONTEXT: Controversy regarding the best operative choice for familial adenomatous polyposis lays between the morbidity of restorative proctocolectomy and the supposed mortality due to rectal cancer after ileorectal anastomosis. OBJECTIVES: To evaluate operative complications and oncological outcome after ileorectal anastomosis and restorative proctocolectomy. METHODS: Charts from patients treated between 1977 and 2006 were retrospectively analyzed. Clinical and endoscopic data, results of treatment, pathological reports and information regarding early and late outcome were recorded. RESULTS: Eighty-eight patients - 41 men (46.6%) and 47 women (53.4%) - were assisted. At diagnosis, 53 patients (60.2%) already had associated colorectal cancer. Operative complications occurred in 25 patients (29.0 %), being 17 (19.7%) early and 8 (9.3%) late complications. There were more complications after restorative proctocolectomy (48.1%) compared to proctocolectomy with ileostomy (26.6%) and ileorectal anastomosis (19.0%) (P = 0,03). There was no operative mortality. During the follow-up of 36 ileorectal anastomosis, cancer developed in the rectal cuff in six patients (16,6%). Cumulative cancer risk after ileorectal anastomosis was 17.2% at 5 years, 24.1% at 10 years and 43.1% at 15 years of follow-up. Age-dependent cumulative risk started at 30 years (4.3%), went to 9.6% at 40 years, 20.9% at 40 years and 52% at 60 years. Among the 26 patients followed after restorative proctocolectomy, it was found cancer in the ileal pouch in 1 (3.8%). CONCLUSIONS: 1. Operative complications occurred in about one third of the patients, being more frequently after the confection of ileal reservoir; 2. greater age and previous colonic carcinoma were associated with the development of rectal cancer after ileorectal anastomosis; 3. patients treated by restorative proctocolectomy are not free from the risk of pouch degeneration; 4. the disease complexity and the various risk factors (clinical, endoscopic, genetic) indicate that the best choice for operative treatment should be based on individual features discussed by a specialist; 5. all patients require continuous and long-term surveillance during postoperative follow-up.

A Comparison of Adverse Events and Functional Outcomes After Restorative Proctocolectomy for Familial Adenomatous Polyposis and Ulcerative Colitis

2006 ◽  
Vol 49 (9) ◽  
pp. 1293-1306 ◽  
Author(s):  
Richard E. Lovegrove ◽  
Henry S. Tilney ◽  
Alexander G. Heriot ◽  
Alexander C. von Roon ◽  
Thanos Athanasiou ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Familial Adenomatous Polyposis ◽  
Adverse Events ◽  
Restorative Proctocolectomy ◽  
Functional Outcomes ◽  
Adenomatous Polyposis
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