QUALITY-OF-LIFE AFTER RESTORATIVE PROCTOCOLECTOMY

被引：8

作者：

ANSELINE, PF

机构：

[1] Department of General Surgery, Royal Newcastle Hospital, Newcastle, New South Wales

来源：

AUSTRALIAN AND NEW ZEALAND JOURNAL OF SURGERY | 1990年 / 60卷 / 09期

关键词：

ileo‐anal reservoir; pouch; quality of life; restorative proctocolectomy; ulcerative colitis;

D O I：

10.1111/j.1445-2197.1990.tb07456.x

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

An audit of 18 patients whom the author managed by abdominal colectomy, rectal mucosectomy and ileo‐anal reservoir anastomosis was undertaken to assess the resulting quality of life. Sixteen patients had ulcerative colitis and two had familial adenomatous polyposis. In each case. a temporary loop ileostomy was performed at the time of reservoir construction. The minimum time since stoma closure was 12 months. The mean number of daily evacuations after stoma closure was eight (range: 4–15). Six patients usually had daytime soiling and eight overnight soiling. Nine patients always wore a perincal pad. Six patients had significant urgency of defecation and 15 patients took medication to reduce bowel frequency. Anorectal problems were noted by all but one of the 18 patients. However, of 14 patients who had lost time from work prior to operation. 12 have returned to uninterrupted employment. Of 11 patients who were unable to travel because of colitis symptoms, eight have no restrictions postoperatively. Twelve patients noted that their diets were more varied since surgery. Of fourteen patients who had restricted sex lives because of colitis symptoms. 11 were subsequently not restricted. On the other hand, during the 3 months the ileostoiny was required, scxual activity was restricted in all but one patient. Other aspects of life also restricted by the stonia were sporting activity (14) and social life (15). Improvement followed stoma closure. Overall. the patients graded the success of the reservoir surgery as excellent (7), very good (3), good (2), satisfactory (4), poor (0), or prefer ileostomy (2). Thirteen patients believed their total lifestyle had improved. The survey suggests that, although not perfect, restorative proctocolectomy is a reasonable option for patients who require surgery for ulcerative colitis or adenomatous polyposis. Copyright © 1990, Wiley Blackwell. All rights reserved

引用

页码：683 / 688

页数：6

共 29 条

[21]

Dozots R.R., Goldberg S.M., Rothenberger D.A., Utsunomiya J., Nicholls R.J., Cohen Z., Hulten L.A.G., Moskowitz R.L., Symposium: Restorative proctocolectomy with ileal reservoir, International Journal of Colorectal Disease, 1, pp. 2-19, (1986)

[22]

Bartolo D.C.C., Miller R., Mortensen N.J., Mc C., Does preservation of the anal transitional zone influence sensation after ileo‐anal anastoinosis for ulcerative colitis, Proceedings of the 87th Annual Convention of American Society of Colon & Rectal Surgeons, (1988)

[23]

Keighley M.R.B., Winslet M.C., Yoshioka K., Lightwood R., Discrimination is not impaired by excision of the anal transition zone after restorative proctocolectomy, Brit. J. Surg., 74, pp. 1118-1121, (1987)

[24]

Scott N.A., Pemberton J.H., Barkel D.C., Wolff B.G., Anal and ileal pouch manometric measurements before ileostomy closure are related to functional outcome after ileal pouch anal anastomosis, Brit. J. Surg., 76, pp. 613-616, (1989)

[25]

Keighley M.R.B., Abdominal mucosectomy reduces the incidence of soiling and sphincter damage after restorative proctocolectomy and J‐pouch, Dis. Colon Rectum, 30, pp. 386-390, (1987)

[26]

Williams N.S., Stapling technique for pouch anal anastomosis without the need for purse‐string sutures, Brit. J. Surg., 76, pp. 348-349, (1989)

[27]

Kmiot W.A., Keighley M.R.B., Totally stapled abdominal restorative proctocolectomy, Brit. J. Surg., 76, pp. 961-964, (1989)

[28]

Laverty I.C., Tuckson W.B., Easley K.A., Internal anal sphincter function after total abdominal colectomy and stapled ileal pouch anal anastomosis without mucosal proctectomy, Dis. Colon Rectum, 32, pp. 950-953, (1989)

[29]

Cohen Z., McLeod A.M., Churchill D.N., Isbister S., Quality of life (QL) of patients with ulcerative colitis pre‐operatively and postoperatively, Proceedings of the International Symposium on New, Trends in Pelvic Pouch Procedures, (1989)

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