[Restorative proctocolectomy with J-pouch reservoir. Experience in a national medical center].

OBJECTIVE

To present the experience for morbidity and mortality of surgical treatment of chronic ulcerative colitis (CUC) and familiar adenomatous polyposis (FAP) with restorative proctocolectomy with J-pouch.

MATERIAL AND

METHODS

We used a cases series of patients treated consecutively from January 1993 to December 2003. Selection criteria were patients with J-pouch restorative proctocolectomy with CUC and FAP who were treated and assessed prospectively.

RESULTS

There were 16 cases treated with restorative proctocolectomy (nine males and seven females). Diagnosis of inflammatory bowel disease was established in 12 patients, and 4 with familiar adenomatous polyposis. Age average was 33 years. All cases had protective ileostomy. Seven patients developed at least one complication such as pelvic abscess, uretheral transection, pulmonary thromboembolism, hemoperitoneum, persistent transrectal bleeding, wound infection and sexual impotence. Only four patients required surgical reintervention. The median hospital stay was 11.9 days. Average bowel movements at 3 month-follow-up was 10.1, at 6 months 6.6. Medium average follow-up was 44.25 months. There was no mortality.

CONCLUSIONS

Results of this study demonstrated adequate quality of life and appropriate functional results; rate of morbidity was acceptable with no mortality.independent of morbidity there was no mortality. Long-term follow up is necessary to identify long-term-late complications.