Is an ileal pouch an alternative for patients requiring surgery for Crohn's proctocolitis?

• Most surgeons consider Crohn's colitis to be an absolute contraindication for a continent ileostomy, due to high complication and failure rates. This opinion may, however, be erroneous. The results may appear poor when compared with those after pouch surgery in patients with ulcerative colitis (UC), but the matter may well appear in a different light if the pouch patients are compared with Crohn's colitis patients who have had a proctocolectomy and a conventional ileostomy.We assessed the long-term outcomes in a series of patients with Crohn's colitis who had a proctocolectomy and a continent ileostomy (59 patients) or a conventional ileostomy (57 patients). The median follow-up time was 24 years for the first group and 27 years for the second group.The outcomes in the two groups of patients were largely similar regarding both mortality and morbidity; the rates of recurrent disease and reoperation with loss of small bowel were also similar between groups.The possibility of having a continent ileostomy, thereby avoiding a conventional ileostomy-even if only for a limited number of years--may be an attractive option for young, highly motivated patients.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)

Nyckelord

Adult

Colonic Pouches

Crohn Disease

complications

diagnosis

Female

Follow-Up Studies

Humans

Ileostomy

adverse effects

methods

Incidence

Male

Middle Aged

Postoperative Complications

epidemiology

Probability

Proctocolectomy

Restorative

adverse effects

methods

Proctocolitis

complications

etiology

mortality

surgery

Reoperation

statistics & numerical data

Retrospective Studies

Risk Assessment

Severity of Illness Index

Survival Rate

Time Factors

Treatment Outcome

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)