궤양성 대장염 환자에게 시술된 복원성 대장직장절제술 50예 = Restorative Proctocolectomy in 50 Patients with Ulcerative Colitis

다국어 초록 (Multilingual Abstract)

Background/Aims: This study was performed to investigate the complications and functional outcomes after restorative proctocolectomy (RP) in patients with ulcerative colitis. Methods: Fifty patients (M:F=24:26) who underwent RP were enrolled. Postoperative complications and functional outcomes after RP were analyzed retrospectively by reviewing the medical records. Median follow-up period was 36 (6-80) months. Results: Among 50 RP cases, RP was performed by staged operation because of poor conditions in 2 cases. Pouch-anal anastomoses were performed by stapled technique in 31 (62.0%) cases and hand-sewn method in 19 (18.0%) cases. Diverting ileostomy was constructed in 31 cases (62.0%). Twenty-five (50.0%) patients showed the complication and one mortality was identified. Pouchitis was the most prevalent complication, followed by 9 cases (18.0%) of small bowel obstruction and 6 cases of anastomosis leakage (12.0%). Pouch-vaginal fistula and entero-cutaneous fistula were observed in 3 and 2 cases, respectively. Anastomosis leakage developed more frequently in RP without ileostomy (26.3% vs. 3.2%, p=0.018). Pouch failure rate was 4.0%. Daily bowel movements were (2-10). One fecal incontinence and six cases of seepage were identified. Conclusions: Restorative proctocolectomy in patients with ulcerative colitis can be performed safely with low mortality and acceptable morbidity. Functional outcomes are complacent, but the technical refinement is needed to improve surgical outcome. (Korean J Gastroenterol 2002;40:379-385)