Restorative Proctocolectomy with Ileal Reservoir and Ileoanal Anastomosis for Ulcerative Colitis and Familial Polyposis

1984 ◽  
Vol 1 (1) ◽  
pp. 19-26 ◽  
Author(s):  
David A Rothenberger ◽  
Douglas Wong ◽  
John G Buls ◽  
Stanley M Goldberg ◽  
Carl E Christenson
Keyword(s):  
Ulcerative Colitis ◽  
Restorative Proctocolectomy ◽  
Familial Polyposis ◽  
Ileoanal Anastomosis ◽  
Ileal Reservoir

RESTORATIVE PROCTOCOLECTOMY WITH ILEAL RESERVOIR AND ILEOANAL ANASTOMOSIS: A CLINICO-PHYSIOLOGICAL STUDY

1987 ◽  
Vol 57 (8) ◽  
pp. 555-558 ◽  
Author(s):  
DenisW. King ◽  
DavidZ. Lubowski ◽  
NicholasA. Talley ◽  
DonaldS. Pryor
Keyword(s):  
Restorative Proctocolectomy ◽  
Ileoanal Anastomosis ◽  
Physiological Study ◽  
Ileal Reservoir

scholarly journals Stapled Ileoanal Anastomosis for Ulcerative Colitis and Familial Polyposis Without a Temporary Diverting Ileostomy

1991 ◽  
Vol 213 (6) ◽  
pp. 606-619 ◽  
Author(s):  
HARVEY J. SUGERMAN ◽  
HEBER H. NEWSOME ◽  
GAYLE DECOSTA ◽  
ALVIN M. ZFASS
Keyword(s):  
Ulcerative Colitis ◽  
Familial Polyposis ◽  
Ileoanal Anastomosis ◽  
Diverting Ileostomy

scholarly journals Indications and Contraindications to Reconstructive Surgery in Ulcerative Colitis

1995 ◽  
Vol 9 (1) ◽  
pp. 33-38
Author(s):  
David Johnston
Keyword(s):  
Ulcerative Colitis ◽  
Restorative Proctocolectomy ◽  
Reconstructive Surgery ◽  
Transitional Zone ◽  
Ileal Reservoir ◽  
High Dose ◽  
Sphincter Pressure ◽  
Indeterminate Colitis ◽  
Sphincter Function ◽  
Risk Of Cancer

Surgical treatment is often needed for patients with ulcerative colitis because of toxic dilation, intractability or risk of cancer. Precise diagnosis is vital to exclude Crohn's disease and infective colitis, although patients with `indeterminate' colitis often do well after reconstructive surgery. Restorative proctocolectomy, in which the anal sphincter is preserved and a pelvic ileal reservoir is used as a substitute for the rectum, is the standard surgical procedure, supplanting panproctocolectomy with ileostomy. Ileorectal anastomosis should also be considered, but is only suitable for patients with relative rectal sparing, and meticulous sigmoidoscopic follow-up is essential. For toxic dilation, colectomy with ileostomy and mucous fistula is recommended, proctectomy and reconstruction being deferred until the patient is fitter. For most patients, the entire colon and rectum are removed and a pelvic ileal reservoir is anastomosed to the anus. Many types of reservoir have been proposed, but randomized trials are few, and it seems that the J pouch is as good as the S or W pouches, and technically is simpler. The operative mortality of restorative proctocolectomy worldwide has been about 1%, thanks largely to the routine use of a temporary defunctioning ileostomy. A one-stage procedure without ileostomy is permissible if the patient is relatively fit and the surgeon is in attendance for 10 days after operation, but omission of the ileostomy certainly increases the risk to life and the postoperative morbidity, and should thus not be done in debilitated patients or in those on high dose steroids. Resection of the mucosal lining of the anal canal above the dentate line (`mucosal proctectomy') was formerly routine, but leads to diminished sphincter pressure and sensation, such that preservation of the entire motor and sensory sphincteric complex is now advocated by many authors. Omission of mucosal stripping renders the procedure technically simpler and quicker, and is associated with better sphincter function, with less fecal leakage. However, a small rim of inflamed mucosa may then be left above the anal transitional zone which theoretically could lead to risk of recurrent inflammation or even predispose to malignant change.

scholarly journals Outcome of restorative proctocolectomy with ileal reservoir for ulcerative colitis: comparison of distal colitis with more proximal disease.

Gut ◽  
1996 ◽  
Vol 38 (4) ◽  
pp. 574-577 ◽  
Author(s):  
D N Samarasekera ◽  
J F Stebbing ◽  
M G Kettlewell ◽  
D P Jewell ◽  
N J Mortensen
Keyword(s):  
Ulcerative Colitis ◽  
Restorative Proctocolectomy ◽  
Ileal Reservoir

Adenocarcinoma Arising Below an Ileoanal Anastomosis After Restorative Proctocolectomy for Ulcerative Colitis: Report of a Case

Surgery Today ◽  
2007 ◽  
Vol 37 (7) ◽  
pp. 596-599 ◽  
Author(s):  
Hirofumi Ota ◽  
Keiji Yamazaki ◽  
Wakio Endoh ◽  
Shigeyuki Hojo ◽  
Hiroki Fukunaga ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Restorative Proctocolectomy ◽  
Ileoanal Anastomosis

Restorative proctocolectomy with ileal reservoir and ileoanal anastomosis

1983 ◽  
Vol 145 (1) ◽  
pp. 82-88 ◽  
Author(s):  
David A. Rothenberger ◽  
Fred D. Vermeulen ◽  
Carl E. Christenson ◽  
Emmanuel G. Balcos ◽  
Frederic D. Nemer ◽  
...  
Keyword(s):  
Restorative Proctocolectomy ◽  
Ileoanal Anastomosis ◽  
Ileal Reservoir

Radiologic Evaluation of the Continent (S-Pouch) Ileal Reservoir with Anal Anastomosis

1986 ◽  
Vol 27 (3) ◽  
pp. 301-304 ◽  
Author(s):  
V. Hennild ◽  
H. Kjærgård ◽  
L. Kuld Hansen
Keyword(s):  
Ulcerative Colitis ◽  
Familial Polyposis ◽  
Pelvic Abscess ◽  
Contrast Enema ◽  
Ileal Reservoir ◽  
Radiographic Findings ◽  
Radiologic Evaluation ◽  
Anal Anastomosis ◽  
Radiologic Investigation ◽  
Fluid Levels

A radiologic investigation was performed in 26 patients subjected to colectomy, mucosal proctectomy and endorectal ileo-anal anastomosis after the creation of an ileal reservoir. The patients had suffered from ulcerative colitis or familial polyposis. The reservoir and its efferent leg was best demonstrated by contrast enema. The size and position of the reservoir and the efferent leg was demonstrated, and stenoses, abscesses and fistulae could be identified. Examination of the small bowel with a contrast medium showed slight dilatation of the ileum orally to the reservoir in all instances and one patient had a stenosis at the junction of the afferent leg of the reservoir. Erect and supine projections of the abdomen showed gas in the intestine and fluid levels in the reservoir. These radiographic findings should not be confused with ileus or pelvic abscess. Radiology was of great value in disclosing postoperative complications. References

Sign in / Sign up

Export Citation Format

Share Document