The fate of the rectal stump after subtotal colectomy for ulcerative colitis |
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Authors: | John R Oakley MD Dr Ian C Lavery MD Victor W Fazio MD David G Jagelman MD Frank L Weakley MD Kirk Easley MS MA |
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Institution: | (1) Department of Biostatistics, The Cleveland Clinic Foundation, Cleveland, Ohio;(2) Department of Colorectal Surgery, The Cleveland Clinic Foundation, 9500 Euclid Avenue, 44106 Cleveland, Ohio |
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Abstract: | In a retrospective review of 311 patients having subtotal colectomy for ulcerative colitis, information on the fate of the
rectal stump was obtained in 288. Proctectomy was performed in 159 patients (55 percent); for persistent proctitis in 118
(41 percent), cancer prophylaxis in 37 (13 percent), and cancer in four (1.4 percent). One hundred twenty-two patients (42
percent) had ileorectal anastomoses. Eighty-four of these (69 percent) retained a functioning ileorectal anastomosis at the
time of follow-up or death, one to 22 years later, and an additional six patients (5 percent) had a satisfactory ileorectal
anastomosis for five to 14 years before proctectomy. Cancer developed in the rectal stump in nine patients (3.1 percent),
underscoring the need for either proctectomy (total or mucosal) or long-term surveillance of the retained rectum. However,
subtotal colectomy, by permitting ileorectal anastomosis or other sphincter-preserving surgery at a later date, does have
a definite place in many patients requiring surgery for ulcerative colitis.
Read at the joint meeting of the American Society of Colon and Rectal Surgeons with the Section of Colo-Proctology, Royal
Society of Medicine, and the Section of Colonic and Rectal Surgery, Royal Australasian College of Surgeons, New Orleans, Louisiana,
May 6 to 11, 1984. |
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Keywords: | Ulcerative colitis Colectomy Ileorectal anastomosis Rectal cancer |
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