Sphincter Preservation in Surgery for Inflammatory Large-Bowel Disease

  • U. Stoffel
  • A. Akovbiantz
Conference paper


Recently the therapy of inflammatory large-bowel disease has changed. This is because of several important innovations in the operative treatment and better medical management. Without doubt the pelvic pouch with ileoanal anastomosis procedure after proctocolectomy is of great importance [1, 3, 14, 15, 18]. This continence-preserving operation has been carried out at our clinic since 1987. Based on a review of the literature and our own very limited experience, we will attempt to give some guidelines for the surgical therapy of inflammatory large-bowel disease. The aim of our treatment concept is to give the patient an optimum chance of preserving continence and to improve the results.


Ulcerative Colitis Familial Adenomatous Polyposis Loop Ileostomy Subtotal Colectomy Restorative Proctocolectomy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Beart RW (1988) Proctocolectomy and ileoanal anastomosis. World J Surg 12: 160–163PubMedCrossRefGoogle Scholar
  2. 2.
    Bloom RJ, Larsen CP, Watt R, Oberhelman HA (1986) A reappraisal of the Kock continent ileostomy in patients with Crohn’s disease. Surg Gynecol Obstet 162: 105–108PubMedGoogle Scholar
  3. 3.
    Cohen Z, McLeod RS, Stern H, Grant D, Nordgren S (1985) The pelvic pouch and ileoanal anastamosis procedure. Am J Surg 150: 601–607PubMedCrossRefGoogle Scholar
  4. 4.
    Dozois RR, Goldberg SM, Rothenberger DA, Utsunomiya J, Nicholls RJ, Cohen Z, Hulten LAG, Moskowitz RL (1986) Restorative proctocolectomy with ileal reservoir. Symposium. Int J Colorectal Dis 1: 2–19CrossRefGoogle Scholar
  5. 5.
    Fazio VW, Church JM (1988) Complications and function of the continent ileostomy at the Cleveland Clinic. World J Surg 12: 148–154PubMedCrossRefGoogle Scholar
  6. 6.
    François Y, Dozois RR, Kelly KA, Beart RW, Wolff BG, Pemberton JH, Ilstrup DM (1989) Small intestinal obstruction complicating ileal pouch-anal anastomosis. Ann Surg 209: 46–50PubMedCrossRefGoogle Scholar
  7. 7.
    Goligher JC (1988) Surgical treatment of Crohn’s disease affecting mainly or entirely the large bowel. World J Surg 12: 186–190PubMedCrossRefGoogle Scholar
  8. 8.
    Hawley PR (1988) Emergency surgery for ulcerative colitis. World J Surg 12: 169–173PubMedCrossRefGoogle Scholar
  9. 9.
    Morel P, Hawker PC, Allan RN, Dykes PW, Alexander-Williams J (1986) Management of acute colitis in inflammatory bowel disease. World J Surg 10: 814–819PubMedCrossRefGoogle Scholar
  10. 10.
    Mortensen N (1988) Progress with the pouch — restorative proctocolectomy for ulcerative colitis. Gut 29: 561–565PubMedCrossRefGoogle Scholar
  11. 11.
    Nicholls RJ, Holt SDH, Lubowski DZ (1989) Restorative proctocolectomy with ileal reservoir. Comparison of two-stage vs. three-stage procedures and analysis of factors that might affect outcome. Dis Colon Rectum 32: 323–326PubMedCrossRefGoogle Scholar
  12. 12.
    Parks AG, Nicholls RJ, Belliveau P (1980) Proctocolectomy with ileal reservoir and anal anastomosis. Br J Surg 67: 533–538PubMedCrossRefGoogle Scholar
  13. 13.
    Rothenberger DA, Vermeulen FD, Christenson Ce, Balcos EG, Nemer FD, Goldberg SM, Bellirean P, Nivatvongs S, Schotten JL, Fang DT, Kennedy HL (1983) Restorative proctocolectomy with ileal reservoir and ileoanal anastomosis. Am J Surg 145: 82–88PubMedCrossRefGoogle Scholar
  14. 14.
    Scott NA, Dozois RR, Beart RW, Pemberton JH, Wolff BG, Ilstrup DM (1988) Postoperative intra-abdominal and pelvic sepsis complicating ileal pouch-anal anastomosis. Int J Colorectal Dis 3: 149–152PubMedCrossRefGoogle Scholar
  15. 15.
    Truelove SC, Marks CG (1981) Toxic megacolon part I: pathogenesis, diagnosis and treatment. Clin Gastroenterol 10: 107–117PubMedGoogle Scholar
  16. 16.
    Utsunomiya T, Iwama M, Imajo M, Matsuo A, Sawai S, Yaegashi K, Hirayama R (1980) Total colectomy, mucosal proctectomy and ileoanal anastomosis. Dis Colon Rectum 23: 459–466PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1992

Authors and Affiliations

  • U. Stoffel
  • A. Akovbiantz

There are no affiliations available

Personalised recommendations