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>Journals >Cirujano General >Year 2000, Issue 2


García-Osogobio S, Takahashi MT, Mass W, Arch-Ferrer J, Remes-Troche JM, Cárdenas S
Sphincter preserving surgery in patients with unspecific chronic ulcerative colitis
Cir Gen 2000; 22 (2)

Language: Español
References: 14
Page: 134-137
PDF: 4. Kb.


Full text




ABSTRACT

Antecedents: Total proctocolectomy and ileo-anal anastomosis (PCTAIA) is the procedure of choice for patients with Unspecific Chronic Ulcerative Colitis (UCUC) requiring surgery. Frequency of this disease is low in Mexico; hence, the experience with this procedure is scarce.
Objective: To analyze the surgical morbidity and mortality and the long-term functional results in a series of patients subjected to this type of surgery in a reference hospital of Mexico City.
Setting: Third level health care hospital.
Design: Clinical retrospective and observational study.
Patients and methods: We reviewed the clinical records of patients subjected to surgery due to inespecific chronic ulcerative colitis, at the National Institute of Nutrition (from the Ministry of Health) from January 1987 to June 1997. We analyzed demographic data, surgical indication, surgical morbidity and mortality, long term morbidity and mortality, as well as the functional state on their last medical examination. All were operated directly by, or under the supervision of two surgeons. The technique used was the same in all patients and consisted of total resection of the colon and rectum, resection of the mucous and submucous layers of the anal transition zone, creation of a J-shaped ileal reservoir and manual endo-anal anastomosis.
Results: Average age was of 37 ± 14 years. There were 13 (50%) women and 13 (50%) of men. Total morbidity was of 46% without mortality. Average follow-up was of 24 months, average diurnal evacuations were 4.8%, nocturnal discharge was 20%, none presented incontinence. Three patients presented inflammation of the reservoir that responded favorably to antibiotics. Two patients presented long-term fistulas of the ileal reservoir, but none needed resection. No deaths occurred.
Conclusion: PCTAIA is a feasible surgery in our conditions, accompanied by acceptable rates of morbidity and mortality, and satisfactory functional results.


Key words: Rectal disease, ulcerative colitis, morbidity, recurrence, mortality.


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>Journals >Cirujano General >Year 2000, Issue 2
 

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