Total colectomy and ileorectal anastomosis in ulcerative colitis. 1995

Y Saito, and T Sawada, and N Tsuno, and T Watanabe, and Y Higuchi, and M Shinozaki, and T Muto
First Department of Surgery, University of Tokyo, School of Medicine, Japan.

In an attempt to determine the best indications for the classically adopted ileo-rectal anastomosis (IRA) and the new techniques of restorative proctocolectomy, namely, ileal J-pouch-anal anastomosis (IAA) ilea J-pouch-anal canal anastomosis (IACA), we retrospectively studied 72 surgically treated patients with ulcerative colitis (UC) followed in our surgical department in the period between 1963 and 1994. Compared to these new techniques, IRA had a lower incidence of postoperative fecal incontinence, and was one-stepped in the majority of the patients. No significant difference regarding postoperative bowel function, operation time, volume of bleeding, hospital stay, and the need for postoperative prednisolone was observed. We concluded that IRA is a good procedure that is indicated for patients receiving high-dose prednisolone, for those who need a quick return to social activity, and for those with poor anal function. IACA is a good indication for those patients with good anal function assessed preoperatively, who agree to receive a multi-step operation. For those patients with cancer or dysplasia, IAA should be the operation of first choice.

UI MeSH Term Description Entries
D007082 Ileum The distal and narrowest portion of the SMALL INTESTINE, between the JEJUNUM and the ILEOCECAL VALVE of the LARGE INTESTINE.
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D011239 Prednisolone A glucocorticoid with the general properties of the corticosteroids. It is the drug of choice for all conditions in which routine systemic corticosteroid therapy is indicated, except adrenal deficiency states. Di-Adreson-F,Predate,Predonine,Di Adreson F,DiAdresonF
D012007 Rectum The distal segment of the LARGE INTESTINE, between the SIGMOID COLON and the ANAL CANAL. Rectums
D003082 Colectomy Surgical resection of a portion of or the entire colon. Hemicolectomy,Large Bowel Resection,Colectomies,Hemicolectomies,Large Bowel Resections,Resection, Large Bowel,Resections, Large Bowel
D003093 Colitis, Ulcerative Inflammation of the COLON that is predominantly confined to the MUCOSA. Its major symptoms include DIARRHEA, rectal BLEEDING, the passage of MUCUS, and ABDOMINAL PAIN. Colitis Gravis,Idiopathic Proctocolitis,Inflammatory Bowel Disease, Ulcerative Colitis Type,Ulcerative Colitis
D005242 Fecal Incontinence Failure of voluntary control of the anal sphincters, with involuntary passage of feces and flatus. Bowel Incontinence,Fecal Soiling,Incontinence, Bowel,Incontinence, Fecal,Soilings, Fecal
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000714 Anastomosis, Surgical Surgical union or shunt between ducts, tubes or vessels. It may be end-to-end, end-to-side, side-to-end, or side-to-side. Surgical Anastomosis,Anastomoses, Surgical,Surgical Anastomoses

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