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Matthias Stelzner, MD; Eric W. Fonkalsrud, MD; Geri Lichtenstein

Arch Surg. 1988;123(10):1265-1268.

Abstract
• Ileal reservoirs have been used almost routinely in conjunction with total colectomy and the endorectal ileal pullthrough procedure for ulcerative colitis and familial polyposis. Of 153 patients who underwent surgery at UCLA Medical Center during the past seven years, a comparison was made between 14 patients with an initial reservoir length of greater than 30 cm (large) and 54 patients with a short reservoir (14 to 20 cm). Although patients with long reservoirs had a low stool frequency in the first postoperative year, there was a subsequent increase. During the first two postoperative years, six (43%) of 14 patients developed reservoir enlargement with secondary pouchitis and diarrhea, which severely limited their activities, finally requiring partial resection. Only one of the 14 patients with short reservoirs who underwent surgery more than two years previously had a resection. Complications requiring operative treatment were more than five times greater in patients with long reservoirs. All patients with shortened reservoirs experienced dramatic improvement in their clinical course within one month. Ileal reservoirs of 14 to 16 cm in length appear to provide long-term, excellent clinical function, with an incidence of pouchitis of less than 5%. Symptoms in patients with large reservoirs may be greatly improved by reservoir shortening.

(Arch Surg 1988;123:1265-1268)

Author Affiliations
From the Department of Surgery, UCLA School of Medicine.

Footnotes
Accepted for publication June 20, 1988.

Read before the Annual Meeting of the Southern California Chapter of the American College of Surgeons, Newport Beach, Calif, Jan 23, 1988.

Reprint requests to the Department of Surgery, UCLA School of Medicine, Los Angeles, CA 90024 (Dr Fonkalsrud).

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THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Adaptive Changes in Ileal Mucosal Nutrient Transport Following Colectomy and Endorectal Ileal Pull-Through With Ileal Reservoir
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Arch Surg 1990;125:586-590.
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