Operative Treatment of Ulcerative Colitis: Conventional Proctectomy with Brooke Ileostomy versus Mucosal Proctectomy with Ileoanal Anastomosis

Abstract

Fifty-four patients with ulcerative colitis were operated on during a 3-year period; 35 had conventional proctectomy and Brooke ileostomy, and 19 had mucosal proctectomy, performed from the abdominal side, leaving 1-2 cm of the distal anal mucosa, and a straight ileoanal anastomosis (IAA) without diverting ileostomy. There were no operative deaths. In the ileostomy group 19 (54%) of the patients had a total of 38 reoperations: 10 laparotomies and 28 revisions of a perineal sinus. Three (16%) of the IAA patients had a total of five reoperations: four laparotomies and one closure of a loop ileostomy. All IAA patients had perfect continence day and night and a median stool frequency of 7.5/24 h 1 year after the operation. The ileostomates had significantly longer time out of work, and more urinary, sexual, and Social dysfunctions than the IAA patients. After 2-3 years' follow-up study, all differences in results are greatly in favour of the ileoanal procedure.

Key Words:

• Brooke ileostomy
• ileoanal anastomosis
• proctectomy
• ulcerative colitis