[Creating a pelvic reservoir in the surgical treatment of ulcerative colitis and familial polyposis of the colon]

Abstract

Proctocolectomy and creation of an ileum reservoir with ileo-anal anastomosis is now an established method in the treatment of ulcerative colitis and certain cases of familial polyposis of the colon requiring operative treatment. The ideal type of reservoir is, however, not yet defined and the indications for operation and selection of the patients are still being assessed. The present series comprises 103 patients in whom a J-reservoir was created during the period November 1983 to January 1989. The results were registered prospectively one, three, six and 12 months postoperatively. In eight patients, the reservoir had to be removed on account of septic complications. All of the remaining patients had spontaneous defaecation and scarcely 50% employ constipating agents one year after the operation. The frequency of defaecation becomes reduced gradually from seven (4-14) per 24 hours to four (2-6) after one year. None of the patients are incontinent but over 10% still have periods of minimal soiling which require the use of a pad after one year. The procedure is complicated but must be considered to be safe in experienced hands as more than 90% of the patients achieve a satisfactory or acceptable result. In operations for ulcerative colitis and familial polyposis of the colon, the rectum should be preserved in view of subsequent reconstructive surgery.