The endorectal ileal pouch-anal anastomosis

Abstract

Patients with either chronic ulcerative colitis (108) or familial polyposis coli (5) received an ileal J pouch-anal anastomosis after sphincter-saving proctocolectomy. There were no postoperative deaths. Leaks (radiologic and/or clinical) from the pouch or ileoanal anastomosis occurred in 14% of patients. Small bowel obstruction, requiring operative correction, occurred in 7% and 3%, respectively, of patients after either proctocolectomy or closure of the loop ileostomy. All 66 patients whose diverting ileostomy had been closed for at least 3 mo. could defecate spontaneously and their mean (.+-. SE) stool frequency per 24 h was 9.0 .+-. 1 at 1 mo. and 5.9 .+-. at 12 mo. Major fecal incontinence was observed in 3% of patients, and 2 patients eventually required a permanent ileostomy. The ileal J pouch-anal anastomosis has become the procedure of choice in selected patients who require proctocolectomy.