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KMID : 0356719960120010089
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Journal of the Korean Society of Coloproctology
1996 Volume.12 No. 1 p.89 ~ p.98
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Clinical Experience of Restorative Protocolectomy and Ileal Pouch-Anal Anastomosis
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Jung Ghap-Joong
Jung Il-Kwon
Kim Hyung-Ho
Choi Hong-Jo
Kim Young-Hoon
Joh Se-Heon
Kim Sang-Sun
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Abstract
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Between November 1990 and May 1995, 7 patients underwent restorative proctocolectomy for the treatment of chronic ulcerative colitis(n=5) and of familial adenomatous polyposis(n=2) at the Dong-A Medical Center. J-pouch was made in 5
cases and S-pouch in 1 case. In one case no pouch was made. The aim of this study was to review the postoperative course retrospectively in terms of the management of early and late complications and to asess long-term stool frequency (1∼7, average=4.4 except for 1 case that was 10 per day). Early major complication was anastomotic dehescence in 2 cases(28.6% ), one of whom died of pelvic sepsis (mortality rate: 14.3%). Pouchitis(n= 1), anovaginal fistula(n= 1) and anastomotic stricture(n= 1) developed in late postoperative period. All of the early and late complications except one case were managed successfully by adequate drainage and local irrigation, or anal dilatiation. Stool frequency was gradually decreased in number postoperatively(2∼4/day by 1 year) espeacially, in 1 case with 4 years follow-up(1 ∼2/day).
It is concluded that major early and late complications including anastomotic dehescence and anovaginal fistula can be managed successfully by conservative treatment and long-term stool frequency is clinically acceptable.
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KEYWORD
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Ileal Pouch-Anal Anastomosis, Familial Adenomatous Polyposis(FAP), Ulcerative Colitis
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