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Brian M. Taylor, MD; Robert W. Beart, Jr, MD; Roger R. Dozois, MD; Keith A. Kelly, MD; Sidney F. Phillips, MD

Arch Surg. 1983;118(6):696-701.

Abstract
• The postoperative results of 50 patients who underwent straight ileoanal anastomosis after total colectomy and mucosal proctectomy were compared with those of 74 patients who underwent ileal pouch—anal anastomosis. No deaths occurred. Of the straight ileoanal anastomoses, 32% failed because of sepsis or diarrhea and necessitated abdominal ileostomy; only 1.3% failed in the pouch-anal group (P<.05). Stool frequency among patients followed up for three months or more (straight ileoanal, n = 30; pouch-anal, n = 33) was less in the pouch-anal group (mean ± SEM, 7±1 stools per 24 hours) than in the straight ileoanal group (11 ±1/24 hr, P<.01). Major nocturnal incontinence was also less in the pouch-anal group than in the straight ileoanal group (0% v 20%), and patient satisfaction was better, as measured on a scale of 1 (very poor functional result) to 10 (excellent result) (pouch-anal score, 9; straight ileoanal score, 6; P<.02). We concluded that ileal pouch—anal anastomosis resulted in less diarrhea, better continence, and an improved quality of life when compared with straight ileoanal anastomosis.

(Arch Surg 1983;118:696-701)

Author Affiliations
From the Departments of Surgery (Drs Taylor, Beart, Dozois and Kelly) and Internal Medicine (Dr Phillips), Mayo Clinic, Rochester, Minn.

Footnotes
Accepted for publication Jan 17, 1983.

Read before the 90th annual meeting of the Western Surgical Association, Kansas City, Mo, Nov 17, 1982.

Reprint requests to Department of Surgery, Mayo Clinic, Rochester, MN 55905 (Dr Dozois).

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