Pouchrekonstruktion nach Rektumresektion
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Pouchrekonstruktion nach Rektumresektion. / Debus, E S; Sailer, M; Fuchs, K H; Thiede, A.
in: ZBL CHIR, Jahrgang 126 Suppl 1, 2001, S. 60-63.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Pouchrekonstruktion nach Rektumresektion
AU - Debus, E S
AU - Sailer, M
AU - Fuchs, K H
AU - Thiede, A
PY - 2001
Y1 - 2001
N2 - Pouch reconstruction after resection of the rectum. Functional results after low anterior resection of the rectum and straight end-to-end coloanal anastomosis are often poor. Patients are frequently troubled by the so called "anterior resection syndrome" which comprises faecal incontinence, urge, frequency and fragmentation. To investigate the potential functional benefit of a coloanal pouch reconstruction we conducted a prospective study. Some 55 patients [29 men; median age 66,4 (30-85)] underwent low anterior resection of the rectum followed by coloanal J-pouch reconstruction. Pouch size was 5-7 cm, a temporary stoma was fashioned in 32 patients. Indications for the operation were: 1. rectal cancer: n = 51, 2. recurrent adenoma n = 2, 3. recto-vaginal fistula n = 1 and 4. severe non-specific proctitis n = 1. We observed 5 anastomotic leakages of which two patients required reoperation. A pelvic abscess was encountered in three patients as well as one pelvic haematoma. Micturition was impaired in five patients. To date 47 patients have completed 12 months follow-up after reversal of the ileostomy. Patients were seen at three-monthly intervals. Mean stool frequency/day was 3.9 after 3 and 2.6 after 12 months. After 3 months 38 patients (69 %) reported complete continence which increased to 83 % at 1 year. 18 Patients (33 %) complained of urge defaecation initially, which decreased to 14.5 % after 1 year. Fragmentation was observed in 40 % at 3 and and 22 % at 12 months, respectively. In conclusion, our initial experience with colonic J-pouch reconstruction shows good functional results.
AB - Pouch reconstruction after resection of the rectum. Functional results after low anterior resection of the rectum and straight end-to-end coloanal anastomosis are often poor. Patients are frequently troubled by the so called "anterior resection syndrome" which comprises faecal incontinence, urge, frequency and fragmentation. To investigate the potential functional benefit of a coloanal pouch reconstruction we conducted a prospective study. Some 55 patients [29 men; median age 66,4 (30-85)] underwent low anterior resection of the rectum followed by coloanal J-pouch reconstruction. Pouch size was 5-7 cm, a temporary stoma was fashioned in 32 patients. Indications for the operation were: 1. rectal cancer: n = 51, 2. recurrent adenoma n = 2, 3. recto-vaginal fistula n = 1 and 4. severe non-specific proctitis n = 1. We observed 5 anastomotic leakages of which two patients required reoperation. A pelvic abscess was encountered in three patients as well as one pelvic haematoma. Micturition was impaired in five patients. To date 47 patients have completed 12 months follow-up after reversal of the ileostomy. Patients were seen at three-monthly intervals. Mean stool frequency/day was 3.9 after 3 and 2.6 after 12 months. After 3 months 38 patients (69 %) reported complete continence which increased to 83 % at 1 year. 18 Patients (33 %) complained of urge defaecation initially, which decreased to 14.5 % after 1 year. Fragmentation was observed in 40 % at 3 and and 22 % at 12 months, respectively. In conclusion, our initial experience with colonic J-pouch reconstruction shows good functional results.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Anal Canal/surgery
KW - Colon/surgery
KW - Defecation
KW - Fecal Incontinence/etiology
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Ileostomy
KW - Male
KW - Middle Aged
KW - Postoperative Complications
KW - Proctocolectomy, Restorative/methods
KW - Prospective Studies
KW - Rectal Neoplasms/surgery
KW - Surveys and Questionnaires
KW - Time Factors
U2 - 10.1055/s-2001-19202
DO - 10.1055/s-2001-19202
M3 - SCORING: Zeitschriftenaufsatz
C2 - 11819175
VL - 126 Suppl 1
SP - 60
EP - 63
JO - ZBL CHIR
JF - ZBL CHIR
SN - 0044-409X
ER -