PMID: 8607574Mar 1, 1996Paper

Functional outcome of the double stapled ileoanal reservoir in patients more than 60 years of age

The American Surgeon
P ReissmanS D Wexner

Abstract

Total proctocolectomy with creation of an ileoanal reservoir (IAR) is currently the preferred surgical treatment of mucosal ulcerative colitis and familial adenomatous polyposis. However, the creation of an IAR on older patients is controversial and commonly avoided because of anticipated poor functional results and increased morbidity. We prospectively studied 140 consecutive patients who underwent a double stapled IAR (DSIAR) between 1988 and 1993. We compared the outcome of 14 patients (Group I) 60 years of age or older (mean 65, range 60-71 years; 10 males and 14 females), to 126 patients (Group II) under the age of 60 (mean 37, range 12-59 years; 80 males and 14 females). Mucosal ulcerative colitis and indeterminate colitis were noted, respectively, in 12 (93%) and 1 (7%) patients in Group I and in 94 (75%) and 5 (4%) patients in Group II. In Group II, 21 (16%) patients had familial adenomatous polyposis, and 6 (5%) had a postoperative diagnosis of Crohn's disease. Subjective functional results and anal manometry were assessed in all 14 patients in Group I (100%) and in 110 of the 117 patients in Group II (94%) whose stomas were closed at a mean followup of 24 (3-60) months. Manometry was per- formed before, and 2 and 12 m...Continue Reading

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