J-pouch: change of a method over years.

J-pouch: change of a method over years. Research Abstract Details 

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J-pouch: change of a method over years. Abstract Text:

J Utsunomiya,T Yamamura,M Kusunoki,H Natori,Y Fujimoto,Y Shoji,T Iwama,

Since 1978, J. Utsunomiya has performed total colectomy, mucosal proctectomy and ileoanal anastomosis (IAA) in 105 patients and analysed their results in 97 patients consisting of 61 of familial polyposis (FP) and 36 of ulcerative colitis (UC) those who have been observed for two months to 10 years after operation. The operative procedures were classified in the three modalities. I. the "end to end-long cuff", II. "J-pouch-long cuff" and III. "J-pouch-short cuff" procedure. The success rate has been improved to 93.0% in the procedure III. compare with 74.1% in the II and 61.5% in the I. This improvement was achieved by preservation of reservoir continence, reduction of pelvic sepsis and less damaging of the internal sphincter during operation. Through a series of evolutional modification, the surgical technique has been established to the present method which is constructed with the four principal components: direct anastomosis of J-ileal pouch to the anus, short rectal cuff mucosectomy, anoabdominal approach at prone jack-knife position and routine use of defunctioning ileostomy. With this technique, both FP and UC patients enjoyed excellent or good function in 90% of the cases. Sex of the patient did not influence the functional result, but older patients showed poorer results compared with the younger patients. This procedure can provide a function comparable with ileorectal anastomosis with a technical difficulty similar to that of the abdominal pouch. All patients with FP or UC who require colectomy are candidates for IAA unless they are 60 years or older. For UC a three stage surgical procedure of IAA proceeded by open rectal excluding colectomy could improve the result.(ABSTRACT TRUNCATED AT 250 WORDS)

J-pouch: change of a method over years. Publishing Authors By Initials

J Utsunomiya,T Yamamura,M Kusunoki,H Natori,Y Fujimoto,Y Shoji,T Iwama,

For similar digestive system: gastrointestinal tract: intestines: intestine, large: rectum research abstracts see: digestive system: gastrointestinal tract: intestines: intestine, large: rectum research

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J-pouch: change of a method over years. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Zeitschrift für Gastroenterologie. Verhandlungsban

VOLUME: 24

Page Numbers: 249-51

Journal Abbreviation:

ISSN: 0172-8504

DAY: 12

MONTH: Jul

YEAR: 1989

J-pouch: change of a method over years. Information

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LANGUAGE: eng

NlmUniqueID: 1256344

J-pouch: change of a method over years. Keywords Mesh Terms:

KEYWORDS: Rectum

MESH TERMS: surgery

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Country: GERMANY, WEST

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MEDLINETA: Z Gastroenterol Verh

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