Clinical impact of colectomy and ileorectal anastomosis in the management of Crohn's disease. Issue 3 (March 1984)

• Record Type: Journal Article
• Authors: Ambrose, N S; Keighley, M R; Alexander-Williams, J; Allan, R N
• Is Part Of: Gut. Volume 25:Issue 3(1984)
• Page Start: 223
• Page End: 227
• Publication Date: 1984-03
• Subjects: Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gut.25.3.223
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : We report the outcome of 63 consecutive patients with Crohn's colitis treated by colectomy and ileorectal anastomosis between 1951-1981. There were no operative deaths. Serious postoperative complications occurred in 10 patients. The mean follow up since colectomy was 9.5 years. At 10 years the cumulative reoperation rate was 48% and the cumulative recurrence rate (based upon operative, radiological, and sigmoidoscopic evidence) was 64%. Ten patients have died during follow up. Two-thirds of the patients still under review have an intact ileorectal anastomosis. These results show that colectomy and ileorectal anastomosis is a useful operation in young patients with chronic ill health, diarrhoea, and anaemia in whom there is minimal anorectal disease. For suitable patients, the operation avoids the morbidity of a permanent stoma, pelvic dissection, and rectal excision. Recurrence developing in the ileum proximal to the anastomosis can often be resected and intestinal continuity preserved, whereas anorectal recurrence usually requires proctectomy.