Fate of the rectum after colectomy with ileorectal anastomosis in ulcerative colitis

Abstract

Objective: Aim of the study was to evaluate the cumulative success of colectomy and ileorectal anastomosis in 20 patients with ulcerative colitis. Patients and Methods: Data were collected from patient histories and cumulative success was calculated by the Kaplan-Meier method. Results: Seven of 20 (35%) ileorectal anastomoses were lost. Cumulative success rate was 84% at 5 years, 69% at 10 years and 56% at 20 years. Most common indication for proctectomy was disabling proctitis. Other reasons for failure were postoperative ileal necrosis and persisting presacral infection. Patients with advanced colonic cancer managed relatively well with ileorectal anastomosis until death. No cases of rectal cancer were detected during postoperative follow-up but one moderate dysplasia was treated locally. Conclusion: Ileorectal anastomosis can be chosen for patients who are not suitable for ileoanal operation. Rectal endoscopies are mandatory postoperatively.