PMID: 9189094Jun 1, 1997Paper

Totally stapled restorative proctocolectomy

The British Journal of Surgery
J S McCourtney, I G Finlay

Abstract

Totally stapled restorative proctocolectomy (TSRP) has simplified ileoanal pouch surgery but few reports exist concerning experience with the technique. A retrospective study of operative and functional data in a consecutive series of patients undergoing TSRP was undertaken. TSRP with J pouch formation was attempted in 103 patients between 1988 and 1995 (for ulcerative colitis (87 patients), familial adenomatous polyposis coli (nine), slow transit constipation (six) and hereditary non-polyposis colorectal cancer (one). Three technical failures resulted in 100 patients available for assessment. Case notes were reviewed together with functional assessment by clinical interview and/or postal questionnaire. Median operating time was 200 min, intraoperative blood loss 360 ml and hospital stay 12 days. There were no operative deaths. All but five patients (95 per cent) had loop ileostomy formation with subsequent reversal. There were 29 complications, six of which required further surgical intervention. Six pouches were excised and two patients had a temporary defunctioning ileostomy. Five patients were rediagnosed as having Crohn's disease, of whom four underwent subsequent pouch excision. Pouchitis (in the absence of Crohn's diseas...Continue Reading

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