Review of our ileal pouch experience in the light of literature
Murat Çakır, Serhat Doğan, Tevfik Küçükkartallar, Ahmet Tekin, Şakir Tekin
Department of General Surgery, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
Objective: Retrospective proctocolectomy is a distinguished, sphincter saving treatment used for the treatment of ulcerative colitis and FAP disease. We aimed to evaluate ileal pouch interventions performed at our clinic and their results in the light of literature.
Material and Methods: Medical records of 35 restorative proctocolectomy and J pouch ileo-anal anastomosis surgeries performed at Necmettin Erbakan University, Meram School of Medicine between the years 2006-2013 were retrospectively examined. The patients were assessed according to their age, gender, length of hospital stay, diagnosis, follow-up duration and pouch-related complications. All patients were contacted by phone and they were scheduled for controls at the outpatient clinic.
Results: Nineteen patients were male (54%) and 16 were female (46%). Their mean age was 45 years (21-74). The mean length of hospital stay was 11 (5-20) days. Twenty two (63%) patients were operated on due to FAP, 12 (34%) due to synchronous rectum cancer and colon tumor or polyp, and one (3%) due to ulcerative colitis. All patients received J pouch and protective ileostomy. After the closure of ileostomy, two cases were identified to have J pouch fistulas. The patients were followed up for 6 months to 7 years. They were contacted by phone and they were questioned about their active complaints, number of defecations, urinary and sexual dysfunctions. It was identified that they had 5 (3-8) defecations per day on average and that 4 (11%) cases had one nocturnal defecation. No pouchitis were identified in the follow-up endoscopic examinations.
Conclusion: Restorative proctocolectomy and ileo-anal anastomosis technique is a surgical procedure that can be performed with low rates of morbidity and mortality, including the elderly.
Keywords: Ileal pouches, ileo-anal anastomosis, restorative proctocolectomy
Ethics committee approval was received for this study from the ethics committee of Necmettin Erbakan University Meram Medical Faculty, Non-Invasive Clinical Research Ethics Committee (2014/666).
Written informed consent was obtained from all patients who participated in this study.
Concept - M.Ç., Ş.T.; Design - M.Ç.; Supervision - T.K., A.T.; Funding - M.Ç.; Materials - M.Ç., S.D.; Data Collection and/or Processing - S.D.; Analysis and/or Interpretation - M.Ç.; Literature Review - M.Ç.; Writer - M.Ç.; Critical Review - T.K., A.T.
No conflict of interest was declared by the authors.
The authors declared that this study has received no financial support.