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Ileo-rectal anastomosis in ulcerative colitis: results of a long-term follow-up study.
Ital J Gastroenterol. 1994 Oct-Nov; 26(8):392-7.IJ

Abstract

Colectomy with ileo-rectal anastomosis (IRA) was introduced in the 'fifties as an alternative to proctocolectomy with ileostomy in patients with ulcerative colitis (UC). Seventy-four patients affected by UC and submitted to IRA were followed up with clinical, endoscopic and histological controls for a median follow-up period of 9.5 years (range: 3-25 years). The long-term outcome was assessed by evaluating the course of the proctitis, the need for medical therapy, functional results, the need for rectal excision, and mortality during the follow-up. The patients were classified in three groups according to the type of the outcome (success: low-relapsing proctitis, rare or no need for medical therapy, good functional results; partial failure: relapsing proctitis with frequent need for medical therapy and/or poor functional results; failure: necessity of proctectomy). In order to define the prognostic value the clinical characteristics at surgery (age, gender, duration of disease, rectal inflammation, and type of surgery) were compared in the three groups. The long-term outcome was judged as a success in 46 patients (62%), partial failure in 19 patients (26%) and failure in 9 patients (12%). Only one patient developed cancer in the rectal stump (incidence: 1.3%). None of the clinical parameters at surgery except rectal inflammation influenced the outcome: patients showing moderate or severe inflammation in the rectum at surgery had a higher failure rate than those with mild or no inflammation (p < 0.02). These data confirm that colectomy with IRA is a safe surgical procedure with good functional results in most cases and with a low risk of cancer.(ABSTRACT TRUNCATED AT 250 WORDS)

Authors+Show Affiliations

Cattedra di Gastroenterologia, Università La Sapienza, Roma, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Controlled Clinical Trial
Journal Article

Language

eng

PubMed ID

7703514

Citation

Paoluzi, O A., et al. "Ileo-rectal Anastomosis in Ulcerative Colitis: Results of a Long-term Follow-up Study." The Italian Journal of Gastroenterology, vol. 26, no. 8, 1994, pp. 392-7.
Paoluzi OA, Di Paolo MC, Ricci F, et al. Ileo-rectal anastomosis in ulcerative colitis: results of a long-term follow-up study. Ital J Gastroenterol. 1994;26(8):392-7.
Paoluzi, O. A., Di Paolo, M. C., Ricci, F., Pasquali, C., Iacucci, M., & Paoluzi, P. (1994). Ileo-rectal anastomosis in ulcerative colitis: results of a long-term follow-up study. The Italian Journal of Gastroenterology, 26(8), 392-7.
Paoluzi OA, et al. Ileo-rectal Anastomosis in Ulcerative Colitis: Results of a Long-term Follow-up Study. Ital J Gastroenterol. 1994 Oct-Nov;26(8):392-7. PubMed PMID: 7703514.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ileo-rectal anastomosis in ulcerative colitis: results of a long-term follow-up study. AU - Paoluzi,O A, AU - Di Paolo,M C, AU - Ricci,F, AU - Pasquali,C, AU - Iacucci,M, AU - Paoluzi,P, PY - 1994/10/1/pubmed PY - 1994/10/1/medline PY - 1994/10/1/entrez SP - 392 EP - 7 JF - The Italian journal of gastroenterology JO - Ital J Gastroenterol VL - 26 IS - 8 N2 - Colectomy with ileo-rectal anastomosis (IRA) was introduced in the 'fifties as an alternative to proctocolectomy with ileostomy in patients with ulcerative colitis (UC). Seventy-four patients affected by UC and submitted to IRA were followed up with clinical, endoscopic and histological controls for a median follow-up period of 9.5 years (range: 3-25 years). The long-term outcome was assessed by evaluating the course of the proctitis, the need for medical therapy, functional results, the need for rectal excision, and mortality during the follow-up. The patients were classified in three groups according to the type of the outcome (success: low-relapsing proctitis, rare or no need for medical therapy, good functional results; partial failure: relapsing proctitis with frequent need for medical therapy and/or poor functional results; failure: necessity of proctectomy). In order to define the prognostic value the clinical characteristics at surgery (age, gender, duration of disease, rectal inflammation, and type of surgery) were compared in the three groups. The long-term outcome was judged as a success in 46 patients (62%), partial failure in 19 patients (26%) and failure in 9 patients (12%). Only one patient developed cancer in the rectal stump (incidence: 1.3%). None of the clinical parameters at surgery except rectal inflammation influenced the outcome: patients showing moderate or severe inflammation in the rectum at surgery had a higher failure rate than those with mild or no inflammation (p < 0.02). These data confirm that colectomy with IRA is a safe surgical procedure with good functional results in most cases and with a low risk of cancer.(ABSTRACT TRUNCATED AT 250 WORDS) SN - 0392-0623 UR - https://www.unboundmedicine.com/medline/citation/7703514/Ileo_rectal_anastomosis_in_ulcerative_colitis:_results_of_a_long_term_follow_up_study_ DB - PRIME DP - Unbound Medicine ER -