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Journal of Gastrointestinal Surgery

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01-01-2009 | original article

Does Mesorectal Preservation Protect the Ileoanal Anastomosis after Restorative Proctocolectomy?

Authors: Andreas D. Rink, Irina Radinski, Karl-Heinz Vestweber

Published in: Journal of Gastrointestinal Surgery | Issue 1/2009

Abstract

Background and aims

The technique of rectal dissection during restorative proctocolectomy might influence the rate of septic complications. The aim of this study was to analyze the morbidity of restorative proctocolectomy in a consecutive series of patients who had rectal dissection with complete preservation of the mesorectum.

Patients and methods

One hundred thirty-one patients who had restorative proctocolectomy for chronic inflammatory bowel disease with handsewn ileopouch-anal anastomosis (IPAA) and preservation of the mesorectal tissue were analyzed by chart reviews and a follow-up investigation at a median of 85 (14–169) months after surgery.

Results

Only one of 131 patients had a leak from the IPAA, and one patient had a pelvic abscess without evidence of leakage, resulting in 1.5% local septic complications. All other complications including the pouch failure rate (7.6%) and the incidence of both fistula (6.4%) and pouchitis (47.9%) were comparable to the data from the literature.

Conclusion

The low incidence of local septic complications in this series might at least in part result from the preservation of the mesorectum. As most studies do not specify the technique of rectal dissection, this theory cannot be verified by an analysis of the literature and needs further approval by a randomized trial.

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Title: Does Mesorectal Preservation Protect the Ileoanal Anastomosis after Restorative Proctocolectomy?
Authors: Andreas D. Rink
Irina Radinski
Karl-Heinz Vestweber
Publication date: 01-01-2009
Publisher: Springer-Verlag
Published in: Journal of Gastrointestinal Surgery / Issue 1/2009
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-008-0665-x

At a glance: The STEP trials

Springer Medicine

Does Mesorectal Preservation Protect the Ileoanal Anastomosis after Restorative Proctocolectomy?

Abstract

Background and aims

Patients and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background and aims

Patients and methods

Results

Conclusion

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