Reservorio ileal con anastomosis reservorio anal por colitis ulcerosa: Complicaciones y resultados funcionales a largo plazo

Background: The ileo anal-pouch-anastomosis (IPAA) is the treatment of choice for patients with ulcerative colitis (UC). Aim To analyze the surgical outcomes, long term evolution and functional results of IPAA. Material and methods: All patients subjected to an IPAA, from 1984 to 2006 were identifie...

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Autores principales:	Zárate C,Alejandro, Zúñiga D,Álvaro, Pinedo M,George, López K,Francisco, Molina P,María E, Viviani G,Paola
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2008
Materias:	Colitis, ulcerative Colonic pouches Proctocolectomy restorative
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000400007
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spelling	oai:scielo:S0034-988720080004000072008-06-16Reservorio ileal con anastomosis reservorio anal por colitis ulcerosa: Complicaciones y resultados funcionales a largo plazoZárate C,AlejandroZúñiga D,ÁlvaroPinedo M,GeorgeLópez K,FranciscoMolina P,María EViviani G,Paola Colitis, ulcerative Colonic pouches Proctocolectomy restorative Background: The ileo anal-pouch-anastomosis (IPAA) is the treatment of choice for patients with ulcerative colitis (UC). Aim To analyze the surgical outcomes, long term evolution and functional results of IPAA. Material and methods: All patients subjected to an IPAA, from 1984 to 2006 were identified from a prospectively constructed inflammatory bowel disease database. Surgical variables, postoperative complications and functional evaluation, using Oresland score were analyzed. Chi square, Fischer exact test, T Student, Mann Whitney and binary logistic regression were included in the statistical analysis. Results: In the study period 107 patients, aged 14 to 62 years (61 females), subjected to an IPAA, were identified in this period. All patients, except 4, had a J pouch. All were protected with a loop ileostomy Thirteen patients (12.1%) had specific postoperative complications: pelvic collections in five (4.6%), wound infection in four (3.7%), fistula of the anastomosis in two (1.8%), hemoperitoneum and pouch necrosis in one each. Three (2.7%) patients were reoperated. There was no post-operative (30 days) mortality. A complete follow-up was obtained in 106 of 107 patients: four evolved as Crohn disease; four lost their pouch and two died for other causes. One patient required an ileostomy due to a vaginal fistula. Seventy two patients were followed more than 36 months after ileostomy closure and 92% have a satisfactory intestinal function. In the univariate analysis, poorest intestinal function was related to age of diagnosis of UC and presence of chronic pouchitis. In the multivariate analyses age of diagnosis was associated with poor function. Conclusions: IPAA has a low rate of complications. The long term intestinal function is satisfactory in most patients. A poorer intestinal function was observed in older patients and those with chronic pouchitis)info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.136 n.4 20082008-04-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000400007es10.4067/S0034-98872008000400007
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Colitis, ulcerative Colonic pouches Proctocolectomy restorative
spellingShingle	Colitis, ulcerative Colonic pouches Proctocolectomy restorative Zárate C,Alejandro Zúñiga D,Álvaro Pinedo M,George López K,Francisco Molina P,María E Viviani G,Paola Reservorio ileal con anastomosis reservorio anal por colitis ulcerosa: Complicaciones y resultados funcionales a largo plazo
description	Background: The ileo anal-pouch-anastomosis (IPAA) is the treatment of choice for patients with ulcerative colitis (UC). Aim To analyze the surgical outcomes, long term evolution and functional results of IPAA. Material and methods: All patients subjected to an IPAA, from 1984 to 2006 were identified from a prospectively constructed inflammatory bowel disease database. Surgical variables, postoperative complications and functional evaluation, using Oresland score were analyzed. Chi square, Fischer exact test, T Student, Mann Whitney and binary logistic regression were included in the statistical analysis. Results: In the study period 107 patients, aged 14 to 62 years (61 females), subjected to an IPAA, were identified in this period. All patients, except 4, had a J pouch. All were protected with a loop ileostomy Thirteen patients (12.1%) had specific postoperative complications: pelvic collections in five (4.6%), wound infection in four (3.7%), fistula of the anastomosis in two (1.8%), hemoperitoneum and pouch necrosis in one each. Three (2.7%) patients were reoperated. There was no post-operative (30 days) mortality. A complete follow-up was obtained in 106 of 107 patients: four evolved as Crohn disease; four lost their pouch and two died for other causes. One patient required an ileostomy due to a vaginal fistula. Seventy two patients were followed more than 36 months after ileostomy closure and 92% have a satisfactory intestinal function. In the univariate analysis, poorest intestinal function was related to age of diagnosis of UC and presence of chronic pouchitis. In the multivariate analyses age of diagnosis was associated with poor function. Conclusions: IPAA has a low rate of complications. The long term intestinal function is satisfactory in most patients. A poorer intestinal function was observed in older patients and those with chronic pouchitis)
author	Zárate C,Alejandro Zúñiga D,Álvaro Pinedo M,George López K,Francisco Molina P,María E Viviani G,Paola
author_facet	Zárate C,Alejandro Zúñiga D,Álvaro Pinedo M,George López K,Francisco Molina P,María E Viviani G,Paola
author_sort	Zárate C,Alejandro
title	Reservorio ileal con anastomosis reservorio anal por colitis ulcerosa: Complicaciones y resultados funcionales a largo plazo
title_short	Reservorio ileal con anastomosis reservorio anal por colitis ulcerosa: Complicaciones y resultados funcionales a largo plazo
title_full	Reservorio ileal con anastomosis reservorio anal por colitis ulcerosa: Complicaciones y resultados funcionales a largo plazo
title_fullStr	Reservorio ileal con anastomosis reservorio anal por colitis ulcerosa: Complicaciones y resultados funcionales a largo plazo
title_full_unstemmed	Reservorio ileal con anastomosis reservorio anal por colitis ulcerosa: Complicaciones y resultados funcionales a largo plazo
title_sort	reservorio ileal con anastomosis reservorio anal por colitis ulcerosa: complicaciones y resultados funcionales a largo plazo
publisher	Sociedad Médica de Santiago
publishDate	2008
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000400007
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Reservorio ileal con anastomosis reservorio anal por colitis ulcerosa: Complicaciones y resultados funcionales a largo plazo

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