Aspetti delle complicanze dopo proctocolectomia restaurativa nel trattamento della colite ulcerosa. Revisione della letteratura ed esperienza personale

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COD: 2002_02_161-172 Categorie: ,

P.L. Colombo, F.P. Tinozzi, M. Abelli, M.R. Laera, G. Testone, P. Moglia, S. Albertario, G. Morone, C. Bianchi, S. Tinozzi

Ann. Ital. Chir., LXXIII, 2, 2002

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Purpose: Analysis of complications and causes of failure after stapled restorative proctocolectomy with ileal J pouchanal anastomosis in patients with ulcerative colitis is presented.
Patients and Methods: The procedure was performed in 28 patients, 19 males (68%) and 9 females (32%); diverting ileostomy was always performed.
Results: There was no perioperative mortality. The overall morbidity rate was 31%. Six patients (21%) had pelvic abscess, 2 (7%) pelvic hematoma, 4 patients (14%) presented ileo-anal anastomotic stricture, 1 patient (3,6%) had pouch-vaginal fistula, three patients (11%) presented intestinal obstruction and 7 (25%) pouchitis. Reoperation was necessary in patients with small bowel obstruction and with pouch-vaginal fistula. Septic complications and pouchitis were resolved with medical treatment. Stenosis of the anastomosis required anal dilation. No patient underwent pouch excision for pouch failure.

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