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Fate of the rectum after colectomy and ileostomy for Crohn's colitis

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Diseases of the Colon & Rectum

Abstract

Eighty-four patients had colectomy with ileostomy and oversewing of the rectum for Crohn's colitis. Seventy-two patients were operated on because of intractable disease, colitis in combination with rectal fistulas, and toxic megacolon. The operative mortality was 6 percent, and neither emergency surgery nor treatment with steroids correlated with operative morbidity. After a median 7.7 years of follow-up, 25 ileorectal anastomoses had been undertaken, 16 of which were successful. Twenty-nine proctectomies were performed; the resulting 10-year cumulative risk of proctectomy was 50 percent. While the risk of proctectomy was significantly less among patients with a normal rectum at colectomy compared with patients with proctitis, the initial macroscopic degree of proctitis did not correlate with the risk of subsequent proctectomy. The 5-year cumulative ileal resection rate in 29 patients with a rectumin situbut out of circuit was 29 percent. The possibility of a future ileorectal anastomosis should still be considered in patients with proctocolitis.

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References

  1. Lockhart-Mummery HE, Morson BC. Crohn's disease (regional enteritis) of the large intestine and its distinction from ulcerative colitis. Gut 1960;1:87–105.

    PubMed  CAS  Google Scholar 

  2. Scammell BE, Andrews H, Allan RN, Alexander-Williams J, Keighley MR. Results of proctocolectomy for Crohn's disease. Br J Surg 1987;74:671–4.

    PubMed  CAS  Google Scholar 

  3. Todd IP. Crohn's disease: choice of operation for colitis. Dis Colon Rectum 1975;18:205–6.

    PubMed  CAS  Google Scholar 

  4. Binder SC, Miller HH, Deterling RA Jr. Fate of the retained rectum after subtotal colectomy for inflammatory disease of the colon. Am J Surg 1976;131:201–3.

    Article  PubMed  CAS  Google Scholar 

  5. Sanfey H, Bayless TM, Cameron JL. Crohn's disease of the colon: is there a role for limited resection? Am J Surg 1984;147:38–42.

    Article  PubMed  CAS  Google Scholar 

  6. Khubchandani IT, Sandfort MR, Rosen L, Sheets JA, Stasik JJ, Riether RD. Current status of ileorectal anastomosis for inflammatory bowel disease. Dis Colon Rectum 1989;32:400–3.

    PubMed  CAS  Google Scholar 

  7. Block GE. Surgical management of Crohn's colitis. N Engl J Med 1980;302:1068–70.

    Article  PubMed  CAS  Google Scholar 

  8. Keighley MR, Buchmann P, Lee JR. Assessment of anorectal function in selection of patients for ileorectal anastomosis in Crohn's colitis. Gut 1982;23:102–7.

    PubMed  CAS  Google Scholar 

  9. Burman JH, Cooke WT, Alexander Williams J. The fate of ileorectal anastomosis in Crohn's disease. Gut 1971;12:432–6.

    PubMed  CAS  Google Scholar 

  10. Lockhart-Mummery HE, Ritchie JK. Large intestine. In: Allan RN, Keighley MR, Alexander-Williams J, Hawkins C, eds. Inflammatory bowel diseases. Edinburgh: Churchill Livingstone, 1983:467–8.

    Google Scholar 

  11. Hellers G. Crohn's disease in Stockholm county 1955–1974: a study of epidemiology, results of surgical treatment and long-term prognosis. Acta Chir Scand Suppl 1979;490:1–84.

    PubMed  CAS  Google Scholar 

  12. Goligher JC. The outcome of excisional operations for primary and recurrent Crohn's disease of the large intestine. Surg Gynecol Obstet 1979;148:1–8.

    PubMed  CAS  Google Scholar 

  13. Weterman IT, Peña AS. The long-term prognosis of ileorectal anastomosis and proctocolectomy in Crohn's disease. Scand J Gastroenterol 1976;11:185–91.

    PubMed  CAS  Google Scholar 

  14. Ambrose NS, Keighley MR, Alexander-Williams J, Allan RN. Clinical impact of colectomy and ileorectal anastomosis in the management of Crohn's disease. Gut 1984;25:223–7.

    PubMed  CAS  Google Scholar 

  15. Harper PH, Truelove SC, Lee EC, Kettlewell MG, Jewell DP. Split ileostomy and ileocolostomy for Crohn's disease of the colon and ulcerative colitis: a 20 year survey. Gut 1983;24:106–13.

    PubMed  CAS  Google Scholar 

  16. Burman JH, Thompson H, Cooke WT, Alexander Williams J. The effects of diversion of intestinal contents on the progress of Crohn's disease of the large bowel. Gut 1971;12:11–5.

    PubMed  CAS  Google Scholar 

  17. Scammell B, Ambrose NS, Alexander-Williams J, Allan RN, Keighley MR. Recurrent small bowel Crohn's disease is more frequent after subtotal colectomy and ileorectal anastomosis than proctocolectomy. Dis Colon Rectum 1985;28:770–1.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Surgical Gastroenterology C and Medical Gastroenterology A, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

    H. Harling M.D., J. HegnhØj M.D., T. N. Rasmussen M.D. & S. Jarnum M.D.

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  1. H. Harling M.D.
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  2. J. HegnhØj M.D.
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  3. T. N. Rasmussen M.D.
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  4. S. Jarnum M.D.
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Harling, H., HegnhØj, J., Rasmussen, T.N. et al. Fate of the rectum after colectomy and ileostomy for Crohn's colitis. Dis Colon Rectum 34, 931–935 (1991). https://doi.org/10.1007/BF02049711

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  • DOI: https://doi.org/10.1007/BF02049711

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