RT Journal Article
SR Electronic
T1 Restorative Proctocolectomy: The Current Ochsner Experience
JF Ochsner Journal
JO Ochsner J
FD O. P. Jindal Global University
SP 512
OP 516
VO 13
IS 4
A1 Shahrazad Talebinejad
A1 Terry C. Hicks
A1 David A. Margolin
A1 Charles B. Whitlow
A1 H. David Vargas
A1 David E. Beck
YR 2013
UL http://www.ochsnerjournal.org/content/13/4/512.abstract
AB Background Restorative proctocolectomy with an ileal pouch-anal anastomosis is a technically demanding procedure to treat ulcerative colitis and familial adenomatous polyposis. Since its initial description almost 30 years ago, the operation has undergone technical and perioperative modifications to improve the patient's experience.Methods We performed a retrospective review of the records of patients undergoing restorative proctocolectomy at the Ochsner Clinic Foundation Hospital from 2008 to 2012 and compared data from that period to data from 1989-1995 (prior to laparoscopic pouch surgery) to determine factors associated with patient outcome.Results Ileal pouch-anal procedures were performed in 77 patients. The 30 male and 47 female patients ranged in age from 13 to 63 years (mean, 34.5 years). The indications for the procedure were ulcerative colitis in 62 patients, polyposis coli in 12 patients, and Crohn disease in 3 patients. Forty patients (52%) had laparoscopic-assisted procedures. The overall hospital length of stay for pouch creation averaged 6.9 days (range 3-29) and for ileostomy closure averaged 4.3 days (range 1-15). No perioperative deaths occurred within 30 days. Complications occurred in 37.7% of patients. Compared to a previous report of 72 patients from 1989 to 1995, the recent group had more laparoscopic procedures, shorter hospital stays, a smaller percentage of 3-stage procedures, and fewer general and pouch-related complications. Pouch failures were similar for both groups.Conclusion Advances in operative techniques and perioperative management have improved the outcome of restorative proctocolectomies.