Abstract
The incidence and outcome of pelvic sepsis was analyzed in 210 patients who underwent restorative proctocolectomy for ulcerative colitis (UC) in 197 patients, and for familial adenomatous polyposis (FAP) in 13 patients. Pelvic sepsis developed in 18 patients (8.6%) and a significantly higher incidence was seen in men than in women, at 13.6% vs 3.7%, respectively (P < 0.05). The incidence of pelvic sepsis in patients with UC complicated by toxic megacolon and/or fulminant colitis was significantly higher that in those without any preoperative complications, at 36.4% vs 7.4% (P < 0.05). The incidence of pelvic sepsis following handsewn anastomosis was significantly higher than that following stapled anastomosis, at 15.6% vs 5.5% (P < 0.05). The outcome of pelvic sepsis in patients with a stapled anastomosis was better than that in those with a handsewn anastomosis. The prognosis of women who developed pelvic sepsis was better than that of men who developed pelvic sepsis. The risk factors predisposing to pelvic sepsis were UC, especially when complicated by toxic megacolon and/or fulminant colitis, and male sex, while a handsewn anastomosis was more vulnerable than a stapled anastomosis.
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Truelove SC, Witts LJ (1955) Cortisone in ulcerative colitis. Final report on a therapeutic trial. Br Med J 2:1041–1045
Fleshman JW, Cohen Z, McLeod RS, Stern H, Blair J (1988) The ileal reservoir and ileoanal anastomosis procedure. Factors affecting technical and functional outcome. Dis Col Rectum 31:10–16
Fonkalsrud EW (1987) Update on clinical experience with different surgical techniques of the endorectal pull-through operation for colitis and polyposis. Surg Gynecol Obstet 165:309–316
Kelly KA (1992) Anal sphincter saving operations for chronic ulcerative colitis. Am J Surg 163:5–11
Nicholls RJ, Lubowski DZ(1987) Restorative proctocolectomy, The four loop(w) reservoir. Br J Surg 74:564–566
Schoetz DJ, Coller JA, Veidenheimer MC (1988) Can the pouch be saved? Dis Col Rectum 31:671–675
Wexner SD, Wong WD, Rothenberger DA (1990) The ileoanal reservoir. Am J Surg 159:178–185
Goligher J, Duthie H, Nixon H (1984) Fistula in ano 178–220, surgery of the anus, rectum and colon. Bailliere Tindall, London
Ziv Y, Fazio VW, Church JM, Lavery IC, King TM, Ambrosetti P (1996) Stapled ileal pouch anal anastomoses are safer than handsewn anastomoses in patients with ulcerative colitis. Am J Surg 171:320–323
Luukkonen P, Jarvinen H (1993) Stapled versus hand-sutured ileoanal anastomosis in restorative proctocolectomy. Arch Surg 128:437–440
Reilly WT, Pemberton JH, Wolff BG, Nivatvongs S, Devine RM, Litchy WL, McIntyre PB (1997) Randomized prospective trial comparing ileal pouch-anal anastomosis performed by excising the anal mucosa to ileal pouch-anal anastomosis performed by preserving the anal mucosa. Ann Surg 225:666–677
Fleshman JW, Cohen Z, McLeod RS, Stern H, Blair J (1988) The ileal reservoir and ileoanal anastomosis procedure factors affecting technical and functional outcome. Dis Col Rectum 31:10–16
Ziv Y, Fazio VW, Church JM, Milson JW, Schroeder TK (1995) Safety of urgent restorative proctocolectomy with ileal pouchanal anastomosis for fulminant colitis. Dis Colon Rectum 38:345–349
Ziv Y, Church JM, Fazio VW, King TM, Lavery IC (1996) Effect of systemic steroids on ileal pouch-anal anastomosis in patients with ulcerative colitis. Dis Col Rectum 39:504–508
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Fukushima, T., Sugita, A., Koganei, K. et al. The incidence and outcome of pelvic sepsis following handsewn and stapled ileal pouch anal anastomoses. Surg Today 30, 223–227 (2000). https://doi.org/10.1007/s005950050049
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DOI: https://doi.org/10.1007/s005950050049