Short- and long-term outcomes of ileal pouch-anal anastomosis for ulcerative colitis

Authors

  • Magaly Gemio Teixeira University of São Paulo; Faculty of Medicine; Hospital das Clínicas; Division of Coloproctology
  • Adauto C. Abreu da Ponte University of São Paulo; Faculty of Medicine; Hospital das Clínicas; Division of Coloproctology
  • Manuela Sousa University of São Paulo; Faculty of Medicine; Hospital das Clínicas; Division of Coloproctology
  • Maristela G. de Almeida University of São Paulo; Faculty of Medicine; Hospital das Clínicas; Division of Coloproctology
  • Edésio Silva Filho University of São Paulo; Faculty of Medicine; Hospital das Clínicas; Division of Coloproctology
  • João Elias Calache University of São Paulo; Faculty of Medicine; Hospital das Clínicas; Division of Coloproctology
  • Angelita Habr-Gama University of São Paulo; Faculty of Medicine; Hospital das Clínicas; Division of Coloproctology
  • Desidério R. Kiss University of São Paulo; Faculty of Medicine; Hospital das Clínicas; Division of Coloproctology

DOI:

https://doi.org/10.1590/S0041-87812003000400002

Keywords:

Ulcerative colitis, Ileoanal anastomosis, Ileostomy, Pouchitis

Abstract

Ileal pouch-anal anastomosis was an important advancement in the treatment of ulcerative colitis. The aim of this study was to determine whether early complications of ileal pouch-anal anastomosis in patients with ulcerative colitis are associated with poor late functional results. PATIENTS AND METHODS: Eighty patients were operated on from 1986 to 2000, 62 patients with ileostomy and 18 without. The early and late complications were recorded. Specific emphasis has been placed on the incidence of pouchitis with prolonged follow-up. RESULTS: The ileostomy was closed an average of 9.2 months after the first operation. Fourteen patients were excluded from the long-term evaluation; 6 patients were lost to regular follow-up, 4 died, and 4 patients still have the ileostomy. Of the 4 patients that died, 1 died from surgical complications. Early complications after operation (41) occurred in 34 patients (42.5%). Late complications (29) occurred in 25 patients as follows: 16 had pouchitis, 3 associated with stenosis and 1 with sexual dysfunction; 5 had stenosis; and there was 1 case each of incisional hernia, ileoanal fistula, hepatic cancer, and endometriosis. Pouchitis occurred in 6 patients (9.8%) 1 year after ileal pouch-anal anastomosis, 9 (14.8%) after 3 years, 13 (21.3%) after 5 years, and 16 (26.2%) after more than 6 years. The mean daily stool frequency was 12 before and 5.8 after operation. One pouch was removed because of fistulas that appeared 2 years later. CONCLUSIONS: Ileal pouch-anal anastomosis is associated with a considerable number of early complications. There was no correlation between pouchitis and severe disease, operation with or without ileostomy, or early postoperative complications. The incidence of pouchitis was directly proportional to duration of time of follow-up.

Downloads

Published

2003-01-01

Issue

Section

Original Articles

How to Cite

Short- and long-term outcomes of ileal pouch-anal anastomosis for ulcerative colitis . (2003). Revista Do Hospital Das Clínicas, 58(4), 193-198. https://doi.org/10.1590/S0041-87812003000400002