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. 1986 Oct;204(4):375–383. doi: 10.1097/00000658-198610000-00005

Ileal pouch-anal anastomosis. A single surgeon's experience with 100 consecutive cases.

J M Becker, J L Raymond
PMCID: PMC1251302  PMID: 3767475

Abstract

Between August 1982 and November 1985, 100 patients underwent ileal "J" pouch-anal anastomosis (IPAA) at the University of Utah. All operations were performed in a standard fashion by a single surgeon. Seventy-eight patients were operated on for chronic ulcerative colitis and 22 for familial polyposis coli. Sixty of the patients were male and 40 were female with a mean age of 33.2 years and a range of 11-63 years. Mean +/- SEM operating time was 5.9 +/- 0.4 hours, blood loss was 666 +/- 49 ml, and total hospitalization was 10.1 +/- 0.3 days. No operative deaths occurred. The overall operative morbidity was 13% after IPAA. Clinical "pouchitis" was observed in 18 patients, all of whom were operated on for chronic ulcerative colitis. No patients had frank incontinence. Twenty per cent of patients experienced frequent nocturnal leakage in the early postoperative period with a significant improvement over the ensuing 6 months. Stool frequency at 1, 3, 6, 12, and 24 months was 7.5 +/- 0.2, 6.5 +/- 0.1, 6.2 +/- 0.3, 5.4 +/- 0.1, and 5.4 +/- 0.2, respectively. Stool frequency at 12 months correlated inversely with ileal pouch capacity and the diagnosis of familial polyposis. It is concluded that ileal pouch-anal anastomosis is a safe and effective operation for patients with chronic ulcerative colitis and familial polyposis coli.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Beart R. W., Jr, Dozois R. R., Kelly K. A. Ileoanal anastomosis in the adult. Surg Gynecol Obstet. 1982 Jun;154(6):826–828. [PubMed] [Google Scholar]
  2. Becker J. M. Anal sphincter function after colectomy, mucosal proctectomy, and endorectal ileoanal pull-through. Arch Surg. 1984 May;119(5):526–531. doi: 10.1001/archsurg.1984.01390170026006. [DOI] [PubMed] [Google Scholar]
  3. Becker J. M., Hillard A. E., Mann F. A., Kestenberg A., Nelson J. A. Functional assessment after colectomy, mucosal proctectomy, and endorectal ileoanal pull-through. World J Surg. 1985 Aug;9(4):598–605. doi: 10.1007/BF01656061. [DOI] [PubMed] [Google Scholar]
  4. Fonkalsrud E. W. Endorectal ileoanal anastomosis with isoperistaltic ileal reservoir after colectomy and mucosal proctectomy. Ann Surg. 1984 Feb;199(2):151–157. doi: 10.1097/00000658-198402000-00003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Heppell J., Kelly K. A., Phillips S. F., Beart R. W., Jr, Telander R. L., Perrault J. Physiologic aspects of continence after colectomy, mucosal proctectomy, and endorectal ileo-anal anastomosis. Ann Surg. 1982 Apr;195(4):435–443. doi: 10.1097/00000658-198204000-00009. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Hillard A. E., Mann F. A., Becker J. M., Nelson J. A. The ileoanal J pouch: radiographic evaluation. Radiology. 1985 Jun;155(3):591–594. doi: 10.1148/radiology.155.3.4001358. [DOI] [PubMed] [Google Scholar]
  7. Kelly D. G., Phillips S. F., Kelly K. A., Weinstein W. M., Gilchrist M. J. Dysfunction of the continent ileostomy: clinical features and bacteriology. Gut. 1983 Mar;24(3):193–201. doi: 10.1136/gut.24.3.193. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Kestenberg A., Becker J. M. A new technique of loop ileostomy closure after endorectal ileoanal anastomosis. Surgery. 1985 Jul;98(1):109–111. [PubMed] [Google Scholar]
  9. Martin L. W., Fischer J. E. Preservation of anorectal continence following total colectomy. Ann Surg. 1982 Dec;196(6):700–704. doi: 10.1097/00000658-198212001-00015. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Metcalf A. M., Dozois R. R., Kelly K. A., Beart R. W., Jr, Wolff B. G. Ileal "J" pouch-anal anastomosis. Clinical outcome. Ann Surg. 1985 Dec;202(6):735–739. doi: 10.1097/00000658-198512000-00013. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Parks A. G., Nicholls R. J., Belliveau P. Proctocolectomy with ileal reservoir and anal anastomosis. Br J Surg. 1980 Aug;67(8):533–538. doi: 10.1002/bjs.1800670802. [DOI] [PubMed] [Google Scholar]
  12. RAVITCH M. M. Total colectomy abdominoperineal resection (pan-colectomy) in one stage. Ann Surg. 1956 Oct;144(4):758–767. doi: 10.1097/00000658-195610000-00017. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Schoetz D. J., Jr, Coller J. A., Veidenheimer M. C. Ileoanal reservoir for ulcerative colitis and familial polyposis. Arch Surg. 1986 Apr;121(4):404–409. doi: 10.1001/archsurg.1986.01400040040005. [DOI] [PubMed] [Google Scholar]
  14. Stryker S. J., Kelly K. A., Phillips S. F., Dozois R. R., Beart R. W., Jr Anal and neorectal function after ileal pouch-anal anastomosis. Ann Surg. 1986 Jan;203(1):55–61. doi: 10.1097/00000658-198601000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Taylor B. M., Beart R. W., Jr, Dozois R. R., Kelly K. A., Phillips S. F. Straight ileoanal anastomosis v ileal pouch--anal anastomosis after colectomy and mucosal proctectomy. Arch Surg. 1983 Jun;118(6):696–701. doi: 10.1001/archsurg.1983.01390060018004. [DOI] [PubMed] [Google Scholar]
  16. Utsunomiya J., Iwama T., Imajo M., Matsuo S., Sawai S., Yaegashi K., Hirayama R. Total colectomy, mucosal proctectomy, and ileoanal anastomosis. Dis Colon Rectum. 1980 Oct;23(7):459–466. doi: 10.1007/BF02987076. [DOI] [PubMed] [Google Scholar]

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