Summary
Eighteen cases of operated ulcerative colitis are described. In 15 cases, ileorectal anastomosis was performed. In one case, the rectum had to be excised because of a massive rectal haemorrhage; in another case, the anastomosis had to be separated (Hartmann's operation) because of a dehiscence of the anastomosis. A re-examination of 13 patients shows full continence in 12 cases; one patient was incontinent with regard to flatus. The Karnofsky Index shows 100 in 10 patients, and 90 in 3 patients. The sigmoidoscopy reveals normal rectal mucosa in 6 patients, a moderate colitis in 5 patients and a severe colitis in 2 patients. There are only two indications for rectal excision in our opinion: uncontrollable rectal haemorrhage and carcinoma (dysplasia).
Zusammenfassung
Es wird über 18 Fälle von operativ behandelter Colitis ulcerosa berichtet. 15mal wurde eine Ileorectostomie angelegt. Bei einem Patienten mußte später das Rectum exstirpiert werden wegen einer schweren rectalen Blutung, bei einem anderen Patienten trat eine Anastomosendehiscenz auf, weshalb die Anastomose aufgelassen werden mußte. 13 Patienten wurden nachuntersucht. In 12 Fällen besteht volle Kontinenz, einmal Inkontinenz für Gas. Der Karnofsky-Index beträgt in 10 Fällen 100, in 3 Fällen 90. Die Kontrollrectoskopie zeigte das Rectum in 6 Fällen abgeheilt, in 5 Fällen eine mäßige Colitis und zweimal eine schwere Colitis. Für die Rectumexstirpation bei der Colitis ulcerosa gibt es unseres Erachtens nur 2 Indikationen: die unstillbare Blutung und das Carcinom bzw. die Dysplasie.
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Funovics, J., Kovats, E. & Rauhs, R. Sphinctererhaltende Eingriffe bei Colitis ulcerosa. Langenbecks Arch Chiv 356, 61–64 (1982). https://doi.org/10.1007/BF01270603
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DOI: https://doi.org/10.1007/BF01270603