Eleven years' experience of postoperative morbidity and trends in handsewn ileo-anal anastomosis with pelvic J-pouch for ulcerative colitis.

Background and aims: Restorative proctocolectomy with mucosectomy and handsewn J-pouch-anal anastomosis is the curative operation of choice for ulcerative colitis. The aim of this study was to determine frequencies of various complications at perioperative time (within 30 days after surgery) with this operative method. We also evaluated the chances of failure of this restorative operation and the trends in operative management.

Material and methods: Evaluation was based on a register containing data on all patients operated for ulcerative colitis at our department since the beginning of 1985. Statistical analysis was made for all adult patients (over 18 years) who underwent an operation for ulcerative colitis during the 11 years' time period.

Results: A total of 170 adult patients underwent an elective operation for ulcerative colitis between March 1985 and December 1995. In 154 cases a restorative procedure was intended. In 142 (92%) cases this proved possible, and in 136 of these a handsewn J-pouch-anal anastomosis was created. The chance of failure in the restorative operation was higher in men (p = 0.0314). During the latter five years' period IAA operations were performed more often as a second-stage procedure. Uneventful recovery was reported in 62 (45.5%) cases. One or more complications were encountered in 74 (55.1%) patients. Corticosteroid treatment did not affect leakage frequency. In spite of the high morbidity there were no perioperative deaths.