2005 Volume 58 Issue 10 Pages 861-865
With recent improvements in mucosectomy methods, one-stage operation has been performed for 55.9% of total colectomy and ileoanal anastomosis cases in our institution, while perioperative mortality has been reduced from 3.4% to 1.3% and the ratio of an early functioning pouch increased from 97.4% to 99.7%. Thus, the safety of the surgical procedure is considered to have improved. As for bowel function, the median stool frequency was shown to be 5, and soiling was not observed in more than 90% of the patients during the daytime and in 60% at night. The pouch functioning rate over a long period is dependent on the term of observation. In our study, the number of patients who could not maintain pouch function due to an anal fistula was reduced, as the mucosectomy including the dentate line was excised. As for long-term complications, the cumulative 10-year incidence of pouchitis was 12% lower than that reported in Western countries. Cases with anal lesion complications showed an extremely poor prognosis. The diagnosis of approximately 4% of the cases was changed from ulcerative colitis to Crohn's disease during the cumulative 20-year follow-up period.
