RESTORATIVE PROCTOCOLECTOMY IN ELECTIVE AND EMERGENCY CASES OF ULCERATIVE-COLITIS

被引：22

作者：

HEYVAERT, G ^{[1
]}

PENNINCKX, F ^{[1
]}

FILEZ, L ^{[1
]}

AERTS, R ^{[1
]}

KERREMANS, R ^{[1
]}

RUTGEERTS, P ^{[1
]}

机构：

[1] UZ GASTHUISBERG,DEPT ABDOMINAL SURG,HERESTR 49,B-3000 LOUVAIN,BELGIUM

来源：

INTERNATIONAL JOURNAL OF COLORECTAL DISEASE | 1994年 / 9卷 / 02期

关键词：

D O I：

10.1007/BF00699416

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

A consecutive series of restorative proctocolectomY for ulcerative colitis was reviewed to determine whether an emergency restorative proctocolectomy procedure leads to a higher morbidity, more especially anastomotic leakage. Severity of illness and nature of surgery were divided in two categories: (1) no acute disease and elective surgery (18 patients), (2) acute disease requiring emergency surgery either immediately or within one week of admission (12 patients). Morbidity after elective surgery was 27% and after emergency surgery 66% (P < 0.06). Pouch-anal leakage occurred in 11% and 41% respectively (P = 0.08). Five risk factors significantly influenced the leak rate including preoperative white blood cell count > 10 000/mul (P < 0.02), urgent nature of surgery (P < 0.02), the combination of leucocytosis and urgent nature of surgery (P = 0.02), the combination of leucocytosis and preoperative corticosteroid dose equivalent to greater-than-or-equal-to 200 mg hydrocortisone/24 h (P = 0.006), postoperative pelvic haematoma (P < 0.05). In conclusion, restorative proctocolectomy is contraindicated in emergency circumstances, especially in patients with signs of sepsis on a high corticosteroid dose. To reduce operative risk and number of procedures required, patients with relapsing ulcerative colitis should be referred for restorative proctocolectomy while being in remission.

引用

页码：73 / 76

页数：4

共 22 条

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