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©2014 Baishideng Publishing Group Inc.
World J Gastroenterol. Oct 7, 2014; 20(37): 13211-13218
Published online Oct 7, 2014. doi: 10.3748/wjg.v20.i37.13211
Published online Oct 7, 2014. doi: 10.3748/wjg.v20.i37.13211
Table 1 Morbidity and mortality after ileorectal anastomosis
Series | Period | n | Anastomotic leak (%) | Proctitis (%) | Need for proctectomy (%) | Overall morbidity (%) | Mortality (%) |
da Luz Moreira et al[11] | 1971-2006 | 86 | 2.3 | 28.0 | 53 | 8 | 0 |
Leijonmarck et al[13] | 1955-1984 | 51 | 3.9 | 45.1 | 57 | 16 | 4 |
Pastore et al[15] | 1974-1990 | 48 | 4.4 | 10.4 | 17 | 22.9 | 0 |
Börjesson et al[16] | 1997-2003 | 32 | 3.1 | 9.3 | 12 | 28 | 0 |
Grundfest et al[17] | 1957-1977 | 89 | 9.1 | 11.2 | 21 | 16.1 | 0 |
Elton et al[18] | 1990-1999 | 18 | 5.6 | 11.0 | 17 | 22.2 | 0 |
Andersson et al[19] | 1992-2006 | 105 | 2.8 | 8.6 | 13.3 | 12.4 | 0 |
Lepistö et al[22] | 1978-2000 | 20 | - | 45.0 | 35 | - | 0 |
Oakley et al[23] | 1960-1982 | 288 | - | 41.0 | 55.2 | - | 4.2 |
Table 2 Morbidity and mortality after ileal pouch-anal anastomosis
Table 3 Main advantages and disadvantages of ileorectal anastomosis and ileal pouch-anal anastomosis
IRA | IPAA | |
Advantages | Easier operation | Lower risk of cancer |
Lower infertility rate | No need for medical therapy | |
Lower risk of urinary and sexual dysfunction | Less urgency | |
Fewer bowel movements per day | ||
Better continence | ||
Disadvantages | Need for maintenance therapy | Major operation |
Risk of recurrent/persistent disease | Risk of postoperative complications (pelvic nerves damage, pelvic sepsis, portal vein thrombosis) | |
Higher risk of neoplastic degeneration | Pouchitis | |
Need for strict surveillance | ||
More dietary and work restrictions |
Table 4 Risk of cancer after ileorectal vs ileal pouch-anal anastomosis in ulcerative colitis
Period | n | Follow-upaverage (yr) | Overall cancer rate (%) | Estimated cumulative risk after 20 years (%) | |
Ileorectal anastomosis | |||||
da Luz Moreira et al[11] | 1971-2006 | 86 | 9 | 8 | 14 |
Leijonmarck et al[13] | 1955-1984 | 51 | 13 | 0 | - |
Pastore et al[15] | 1974-1990 | 48 | 6.3 | 2 | 14.31 |
Börjesson et al[16] | 1997-2003 | 32 | 3.5 | 0 | - |
Grundfest et al[17] | 1957-1977 | 89 | 8 | 4.8 | 5 ± 3.5 |
Elton et al[18] | 1990-1999 | 18 | 2.6 | - | - |
Andersson et al[19] | 1992-2006 | 105 | 5.4 | - | 2.1 |
Lepistö et al[22] | 1978-2000 | 20 | 18 | 0 | - |
Oakley et al[23] | 1960-1982 | 288 | 8.2 | 3.1 | - |
Baker et al[26] | 1952-1976 | 374 | > 10 | 5.9 | 6 ± 2 |
Ileo-pouch anal anastomosis | |||||
Kariv et al[44] | 1984-2009 | 3203 | ± 12 | 0.4 | 4 |
Branco et al[45] | 1978-2008 | 520 | ± 15 | 0.2 | - |
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Citation: Scoglio D, Ahmed Ali U, Fichera A. Surgical treatment of ulcerative colitis: Ileorectal
vs ileal pouch-anal anastomosis. World J Gastroenterol 2014; 20(37): 13211-13218 - URL: https://www.wjgnet.com/1007-9327/full/v20/i37/13211.htm
- DOI: https://dx.doi.org/10.3748/wjg.v20.i37.13211