Skip to main content
PMC home page
Gut logoLink to Gut
. 1977 Mar;18(3):236–239. doi: 10.1136/gut.18.3.236

Ileorectal anastomosis in patients with Crohn's disease of the colon.

G Flint, R Strauss, N Platt, L Wise
PMCID: PMC1411382  PMID: 856681

Abstract

Thirty-seven patients were studied who had an ileorectal anastomosis performed for Crohn's disease of the colon. Twenty-nine were done as a primary procedure and in eight the anastomosis was made after previous total or segmental colectomy. Three patients developed anastomotic leaks and all three patients died. No patient who had a diverting loop ileostomy performed at the time of ileorectal anastomosis developed anastomotic leaks before or after the ileostomy was closed. Of the 37 patients, three died postoperatively and another five have had less than a one year follow-up. Of the remaining 29 patients, 12 (41%) had recurrences in either the rectum or ileum. Half of the recurrences took place five or more years after surgery. Seven of the 12 patients with recurrences have had their anastomoses taken down. When this recurrence rate of 41% is compared with the recurrence of ileitis in patients after total colectomy and ileostomy for Crohn's disease of the colon, the incidence of recurrence is, as shown in many reports, not markedly dissimilar. Of the patients who develop a recurrence after ileorectal anastomosis, only about half will have to have their anastomoses taken down. In our study, 59% of the patients had no recurrence and another 20-5% had a recurrence but did not require 'take down' of the anastomosis. Thus, almost 80% of our patients at the time of this report have been able to lead a life unencumbered by an ileostomy, making ileorectal anastomosis for this disease a desirable procedure to consider in selected patients.

Full text

PDF
239

Selected References

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

  1. Baker W. N. Ileo-rectal anastomosis for Crohn's disease of the colon. Gut. 1971 Jun;12(6):427–431. doi: 10.1136/gut.12.6.427. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Burman J. H., Cooke W. T., Williams J. A. The fate of ileorectal anastomosis in Crohn's disease. Gut. 1971 Jun;12(6):432–436. doi: 10.1136/gut.12.6.432. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. CORNES J. S., STECHER M. Primary Crohn's disease of the colon and rectum. Gut. 1961 Sep;2:189–201. doi: 10.1136/gut.2.3.189. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. De Dombal F. T., Burton I., Goligher J. C. Recurrence of Crohn's disease after primary excisional surgery. Gut. 1971 Jul;12(7):519–527. doi: 10.1136/gut.12.7.519. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Farmer R. G., Hawk W. A., Turnbull R. B., Jr Regional enteritis of the colon: a clinical and pathologic comparison with ulcerative colitis. Am J Dig Dis. 1968 Jun;13(6):501–514. doi: 10.1007/BF02233062. [DOI] [PubMed] [Google Scholar]
  6. Glass R. E., Baker W. N. Role of the granuloma in recurrent Crohn's disease. Gut. 1976 Jan;17(1):75–77. doi: 10.1136/gut.17.1.75. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Glotzer D. J., Gardner R. C., Goldman H., Hinrichs H. R., Rosen H., Zetzel L. Comparative features and course of ulcerative and granulomatous colitis. N Engl J Med. 1970 Mar 12;282(11):582–587. doi: 10.1056/NEJM197003122821102. [DOI] [PubMed] [Google Scholar]
  8. Glotzer D. J., Stone P. A., Patterson J. F. Prognosis after surgical treatment of granulomatous colitis. N Engl J Med. 1967 Aug 10;277(6):273–279. doi: 10.1056/NEJM196708102770601. [DOI] [PubMed] [Google Scholar]
  9. Hawk W. A., Turnbull R. B., Jr Primary ulcerative disease of the colon. Gastroenterology. 1966 Nov;51(5):802–805. [PubMed] [Google Scholar]
  10. JANOWITZ H. D., LINDNER A. E., MARSHAK R. H. GRANULOMATOUS COLITIS: CROHN'S DISEASE OF THE COLON. JAMA. 1965 Mar 8;191:825–828. doi: 10.1001/jama.1965.03080100043010. [DOI] [PubMed] [Google Scholar]
  11. Jones J. H., Lennard-Jones J. E., Lockhart-Mummery H. E. Experience in the treatment of Crohn's disease of the large intestine. Gut. 1966 Oct;7(5):448–452. doi: 10.1136/gut.7.5.448. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Korelitz B. I., Present D. H., Alpert L. I., Marshak R. H., Janowitz H. D. Recurrent regional ileitis after ileostomy and colectomy for granulomatous colitis. N Engl J Med. 1972 Jul 20;287(3):110–115. doi: 10.1056/NEJM197207202870302. [DOI] [PubMed] [Google Scholar]
  13. LOCKHART-MUMMERY H. E., MORSON B. C. CROHN'S DISEASE OF THE LARGE INTESTINE. Gut. 1964 Dec;5:493–509. doi: 10.1136/gut.5.6.493. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. LOCKHART-MUMMERY H. E., MORSON B. C. Crohn's disease (regional enteritis) of the large intestine and its distinction from ulcerative colitis. Gut. 1960 Jun;1:87–105. doi: 10.1136/gut.1.2.87. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Nugent F. W., Veidenheimer M. C., Meissner W. A., Haggitt R. C. Prognosis after colonic resection for Crohn's disease of the colon. Gastroenterology. 1973 Sep;65(3):398–402. [PubMed] [Google Scholar]
  16. Steinberg D. M., Allan R. N., Thompson H., Brooke B. N., Alexander-Williams J., Cooke W. T. Excisional surgery with ileostomy for Crohn's colitis with particular reference to factors affecting recurrence. Gut. 1974 Nov;15(11):845–851. doi: 10.1136/gut.15.11.845. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Turnbull R. B., Jr, Schofield P. F., Hawk W. A. Nonspecific ulcerative colitis. I. Introduction. Adv Surg. 1968;3:161–171. [PubMed] [Google Scholar]
  18. Veidenheimer M. C., Dailey T. H., Meissner W. A. Ileorectal anastomosis for inflammatory disease of the large bowel. Am J Surg. 1970 Apr;119(4):375–378. doi: 10.1016/0002-9610(70)90136-4. [DOI] [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES