Comparison of proctocolectomy and ileal pouch-anal XXXX to colectomy and ileorectal @entity254 in @entity1412 .

@entity1 @entity5 @entity254 @entity260 @entity1412
UNASSIGNED: Prophylactic surgical options for @entity1412 ( @entity1412 ) are either colectomy and ileorectal @entity254 (IRA) or proctocolectomy and ileal pouch-anal @entity254 (IPAA). The aim of this study was to analyse the short-term and long-term outcomes of these two operative techniques. All @entity1 with @entity1412 in Finland have been prospectively recorded in a database since 1963 were retrospectively reviewed in this analysis. Altogether 140 (61  %) colectomies with IRA and 88 (39  %) proctocolectomies with IPAA have been performed. Complications occurred in 28 (21  %) @entity1 after IRA and in 26 (30  %) @entity1 after IPAA. There were 15 (11  %) severe complications for IRA and 5 (6  %) for IPAA. Twenty-one (15  %) @entity1 of the IRA group ended up in conventional ileostomy whereas 3 (3.4  %) @entity1 of the IPAA group had their ileal reservoir converted to an ileostomy (p  =  0.01). Cumulative survival for IRA was lower than for the IPAA (p  =  0.03), but if accounting only for operations made after the IPAA era had commenced, there was no significant difference. IPAA was associated with improved long-term survival without an @entity260 . The risk of death after colectomy and IRA seemed to be predominantly related to the remaining risk of @entity5 . Therefore, we favour proctocolectomy with IPAA as the prophylactic surgical procedure for @entity1412 with intermediate or severe @entity1412 .
