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Long-term results of ileorectal anastomosis in ulcerative colitis in Stockholm County

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Diseases of the Colon & Rectum

Abstract

The long-term results of ileorectal anastomosis in patients with ulcerative colitis in Stockholm County over a 30-year period, 1955 to 1984, were investigated. During this time, 486 patients underwent colectomy and ileorectal anastomosis was performed in 60 of those patients (12 percent). A retrospective histologic examination of the slides of the operative specimens in the latter group revealed that nine patients had Crohn's disease. Of the 51 remaining patients with ulcerative colitis, the colectomy and ileorectal anastomosis was performed as an elective procedure in 44 cases (86 percent) and as a one-stage procedure in 48 patients (94 percent). Complications occurred in 7 of 43 patients (16 percent) undergoing an elective, one-stage procedure. There were two postoperative deaths (4 percent). There were 22 patients (43 percent) who had their ileorectal anastomosis in function at the time of follow-up, with a mean time of observation of 13 years. The cumulative probability of having the ileorectal anastomosis in function at 10 years was 51 percent. The causes of rectal excision were recurrent inflammation in the retained rectum (N=23), dysplasia (N=3), and postoperative complications (N=3). No rectal carcinoma occurred. Patients with preoperative mild rectal disease had a better outcome (ileorectal anastomosis in function at time of follow-up) compared with patients with moderate rectal disease (P <0.001). The functional outcome of ileorectal anastomosis was, if anything, better than what is stated in the literature following pelvic pouch procedure.

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References

  1. Lilienthal H. Hyperplastic colitis: extirpation of the entire colon, upper sigmoid and four inches of ileum. Ann Med 1901;1:164–5.

    Google Scholar 

  2. Devine H. Method of colectomy for desperate cases of ulcerative colitis. Surg Gynecol Obstet 1943;76:136–8.

    Google Scholar 

  3. Aylett SO. Three hundred cases of diffuse ulcerative colitis treated by total colectomy and ileorectal anastomosis. Br Med J 1966;1:1001–5.

    Google Scholar 

  4. Johnson WR, Hughes ES, McDermott FT, Katrivessis H. The outcome of patients with ulcerative colitis managed by subtotal colectomy. Surg Gynecol Obstet 1986;162:421–5.

    PubMed  Google Scholar 

  5. Hawley PR. Ileorectal anastomosis. Br J Surg 1985;72(suppl):75–6.

    Google Scholar 

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

    PubMed  Google Scholar 

  7. Williams NS, Johnston D. The current status of mucosal proctectomy and ileo-anal anastomosis in the surgical treatment of ulcerative colitis and adenomatous polyposis. Br J Surg 1985;72:159–68.

    PubMed  Google Scholar 

  8. Pemberton JH, Kelly KA, Bean, Jr RW, Dozois RR, Wolff BG, Ilstrup DM. Ileal pouch-anal anastomosis for chronic ulcerative colitis. Ann Surg 1988;206:504–13.

    Google Scholar 

  9. Danielsson Å, Hellers G, Lyrenäs, et al. A controlled randomized trial of budesonide versus prednisolone retention enemas in active distal ulcerative colitis. Scand J Gastroenterol 1987;22:987–92.

    PubMed  Google Scholar 

  10. Löfberg R, Tribukait B, Öst Å, Broström O, Reichard H. Flow cytometric DNA analysis in longstanding ulcerative colitis: a method of prediction of dysplasia and carcinoma development? Gut 1987;28:1100–6.

    PubMed  Google Scholar 

  11. Nordenvall B, Broström O, Berglund M, et al. Incidence of ulcerative colitis in Stockholm County 1955–1979. Scand J Gastroenterol 1985;20:783–90.

    PubMed  Google Scholar 

  12. Leijonmarck CE, Persson PG, Hellers G. Factors affecting colectomy rate in ulcerative colitis. Gut (in press).

  13. Armitage P. Statistical methods in medical research. Oxford: Blackwell Scientific Publications, 1971.

    Google Scholar 

  14. Oakley JR, Jagelman DG, Fazio V, et al. Complications and quality of life after ileorectal anastomosis for ulcerative colitis. Am J Surg 1985;149:23–30.

    PubMed  Google Scholar 

  15. Liljeqvist L, Lindquist K, Ljungdahl I. Alterations in ileoanal pouch technique, 1980 to 1987: complications and functional outcome. Dis Colon Rectum 1988;31:929–38.

    PubMed  Google Scholar 

  16. Wexner SD, Jensen L, Rothenberger DA, Wong WD, Goldberg SM. Long-term functional analysis of the ileoanal reservoir. Dis Colon Rectum 1989;32:275–81.

    PubMed  Google Scholar 

  17. Baker WN, Glass RE, Ritchie JK, Aylett SO. Cancer of the rectum following colectomy and ileorectal anastomosis for ulcerative colitis. Br J Surg 1978;65:862–8.

    PubMed  Google Scholar 

  18. Oakley JR, Lavery IC, Fazio VW, Jagelman DG, Weakley FL, Easley K. The fate of the rectal stump after subtotal colectomy for ulcerative colitis. Dis Colon Rectum 1985;28:394–6.

    PubMed  Google Scholar 

  19. Farnell MB, van Heerden JA, Beart Jr RW, Weiland LH. Rectal preservation in nonspecific inflammatory disease of the colon. Ann Surg 1980;192:249–53.

    PubMed  Google Scholar 

  20. Leijonmarck CE, Broström O, Monsen U, Hellers G. Surgical treatment of ulcerative colitis in Stockholm County, 1955 to 1984. Dis Colon Rectum 1989;32:918–26.

    PubMed  Google Scholar 

  21. Baker WN. The results of ileorectal anastomosis at St. Mark's Hospital from 1953 to 1968. Gut 1970;11:235–9.

    PubMed  Google Scholar 

  22. Jones PF, Munro A, Ewen EWB. Colectomy and ileorectal anastomosis: report on a personal series, with a critical review. Br J Surg 1977;64:615–23.

    PubMed  Google Scholar 

  23. Gruner OPN, Flatmark A, Naas R, Fretheim B, Gjone E. Ileorectal anastomosis in ulcerative coliltis. Scand J Gastroenterol 1975;10:641–6.

    PubMed  Google Scholar 

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Supported by grants from the Swedish Society of Medicine.

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Leijonmarck, C.E., Löfberg, R., Öst, Å. et al. Long-term results of ileorectal anastomosis in ulcerative colitis in Stockholm County. Dis Colon Rectum 33, 195–200 (1990). https://doi.org/10.1007/BF02134178

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