Totale Colektomie, Recto-Mucosektomie und ileo-anale Anastomose mit Ileum-Reservoir bei der Behandlung der Colitis ulcerosa

Abstract

An operation avoiding a permanent ileostomy is described for patients with ulcerative colitis. The colon and upper half of the rectum are excised and the remaining inflamed mucosa is stripped from the rectal stump down to the dentate line of the anal canal. After excision of all diseased tissue, a reservoir is constructed from the terminal 40 cm of the small intestine. An ileoanal anastomosis via the peranal approach is then carried out. Six patients have been treated, five of whom were followed up for 2-21 months (mean 11 months). One patient died 3 weeks after the operation. The other five are currently well, with no disturbance of urinary or sexual function. The average frequency of evacuation is 5 times in 24 h. Three of these evacuate the reservoir spontaneously and one routinely uses a catheter. (One patient still has an ileostomy). Fecal continence is complete in all during the day and night.

Restorative Prokto-Colektomie mit Ileum-Pouch

“…eines Rezidivs aus und kann in der Prognose quo ad vitam der Ano-Proktocolektomie gleich gesetzt werden [12]. Sie kann auch beim schweren Befall des Rectums durchgefiihrt werden, setzt allerdings voraus, dab der Sphincterapparat intakt ist [1,2,12,13].…”

“…Auch unsere Erfahrung mit dieser Operationsmethode (die Methode wurde bis jetzt insgesamt bei 11 Patienten angewandt) zeigt gute funktionelle Ergebnisse [1,2].…”