The ileoanal pouch procedure in the long-term perspective: a critical review.

• An ileo-pouch anal anastomosis (IPAA) has become the gold standard procedure for ulcerative colitis and familial adenomatous polyposis. Clinical results on the pelvic pouch procedure have often been encouraging; when confronted with the different surgical options, the majority of patients select IPAA as the best operation. However, even if IPAA is a great innovation, it is by no means the first choice for all patients. For patients old enough to join in a responsible discussion, the pros and cons of the various operations must be carefully described; the choice of surgical procedure must meet the patient's wishes and appear soundly based to the surgeon. The young age of most patients has to be considered and a long follow-up time is required to establish whether and, if so, to what extent the operation may adversely impact the patient's continence, sex life, fertility, and quality of life. The risk of cancer transformation in the residual rectal mucosa in the muscular or columnar cuff is another important factor that may influence the eventual decision. This article critically reviews our experience and the literature.

Ämnesord

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

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

Nyckelord

Anal Canal

surgery

Anastomosis

Surgical

Colonic Pouches

adverse effects

standards

Colorectal Neoplasms

mortality

surgery

Fecal Incontinence

Female

Humans

Male

Neoplasm Recurrence

Local

diagnosis

surgery

Postoperative Complications

diagnosis

epidemiology

Pouchitis

diagnosis

epidemiology

Proctocolectomy

Restorative

adverse effects

methods

Prognosis

Quality of Life

Reoperation

Risk Assessment

Surgical Wound Infection

diagnosis

epidemiology

Survival Analysis

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)