Prophylactic surgery in @entity1412 ( XXXX )-a single surgeon's short- and long-term experience with hand-assisted proctocolectomy and smaller J-pouches.

@entity1 @entity322 @entity254 @entity1412 @entity2418
PURPOSE: Prophylactic proctocolectomy with an ileoanal neo-reservoir is the established procedure in non-attenuated @entity1412 ( @entity1412 ). Traditionally, the ileal J-pouch is created by doubling 15  cm of the terminal ileum. Pouch inlet problems are not infrequently encountered in longer pouches. On this rationale, this series reports on the functional outcome and quality of life (QoL) following standardized construction of a @entity2418 with a limb of 8-9  cm length. METHODS: All @entity1 of a single-surgeon series with @entity1412 who underwent hand-assisted laparoscopic proctocolectomy and small ileal pouch-anal @entity254 as the primary procedure between 10/2005 and 04/2010 and responded to the questionnaire were included and retrospectively analyzed. RESULTS: A total of 46 @entity1 (78  %) out of the consecutive series who underwent operation in this period were included in the study. After a mean follow-up of 38  months, 40/46 @entity1 (87  %) did not report any @entity322 and 3 @entity1 (6.5  %) complained about occasional nocturnal @entity322 (3 failed to answer this question). The mean stool frequency per 24  h was 6.25. No significant difference was encountered between the QoL outcome of our @entity1 versus the German normative population. Comparable results were achieved in a study analyzing the long-term results in @entity1412 @entity1 with a 15-cm pouch. CONCLUSIONS: Smaller, 8-9  cm J-pouches show excellent functional results both in short- and in long-term results. The hand-assisted procedure was safe and no conversions were required. QoL is equal to a normative population, as it is in a series of @entity1 with larger J-pouches.
