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Proctocolectomy with ileoanal anastomosis

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Journal of Gastrointestinal Surgery

Conclusion

Ileoanal anastomosis has evolved through many phases before arriving at the highly successful procedure currently used at major centers. Interesting, in reviewing the world’s literature, those series that report patient outcomes stratified by year show significant improvements in function and quality of life in patients who have received the operation more recently when compared with patients receiving the operation in the earlier years. Continued technical advances and greater surgeon experience can only further improve function, outcome, and patient satisfaction. Despite some opposition,31 under elective conditions, IPAA remains an excellent option for patients with CUC and FAP once the decision for surgery has been mutually reached by the patient and surgeon.32 With technical modifications and with experience, mucosal proctectomy and IPAA can now be performed with a low rate of complications, with good functional results and quality of life and excellent long-term outcome. As these patients, especially those with CUC, experience more frequent inflammatory episodes or become refractory to medical management, their medical and surgical management will require a closely coordinated effort by their gastroenterologists and their surgeons. Unless the colectomy is urgent, these patients typically tend to get referred earlier and therefore have more favorable outcomes. Optimal results are obtained by careful patient selection, appropriate preoperative management, meticulous standardized surgical technique, appropriate postoperative education, and rigorous follow-up.

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Authors and Affiliations

  1. Department of Surgery, Boston University Medical Center, 88 East Newton St., 02118, Boston, MA

    James M. Becker M.D. & Arthur F. Stucchi Ph.D.

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  1. James M. Becker M.D.
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  2. Arthur F. Stucchi Ph.D.
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Correspondence to James M. Becker M.D..

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Becker, J.M., Stucchi, A.F. Proctocolectomy with ileoanal anastomosis. J Gastrointest Surg 8, 376–386 (2004). https://doi.org/10.1016/j.gassur.2004.01.001

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