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  • Title: [Ileorectal anastomosis in the surgical treatment of ulcerative colitis: long-term results].
    Author: Bellolio R F, Zúñiga A JM, Wagner H P, Pinedo M G, Duarte G I, Zúñiga D A.
    Journal: Rev Med Chil; 2008 Sep; 136(9):1121-6. PubMed ID: 19030655.
    Abstract:
    BACKGROUND: Total colectomy with ileorectal anastomosis (IRA) is an alternative to the ileoanal pouch for the surgical treatment of ulcerative colitis in a selected group of patients. This technique leaves rectal mucosa liable to develop persistent proctitis, dysplasia and cancer. AIM: To describe short and long-term results of IRA and to assess the presence of dysplasia. MATERIAL AND METHODS: Descriptive study of patients treated with IRA. The data were obtained from the clinical records, and the present status was evaluated with an interview. A proctoscopy and biopsy was offered free of cost to the contacted patients. RESULTS: Between 1978 and 2005, 26 patients were operated. One patient presented an anastomotic leakage that was treated with a loop ileostomy. There was no operative mortality. Twenty-three patients were followed for a period of 1 to 23 years. Three patients evolved as Crohn 's disease and two of them needed a proctectomy. Three patients died of non-related diseases. In the remaining 17, the average evacuation rate was 3.7/24 h and all were continent. None developed a rectal cancer Only two patients had their planned annual endoscopic surveillance. In 2 of the 11 patients who accepted endoscopy and biopsy, a low-grade dysplasia was found. CONCLUSIONS: IRA has low morbidity and acceptable functional results in this selected group of patients. No patient presents high-grade dysplasia or cancer; however, the adherence to the endoscopic follow-up is poor.
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