Restorative proctocolectomy with ileal reservoir

OBJECTIVE: Restoractive proctocolectomy with ileal reservoir is a procedure that eliminates mucosal disease of the colon and rectum yet it preserves fecal continence. It has become the operation of choice for most patients with chronic ulcerative colitis and familial adenomatous polyposis.

METHODS: The study was carried out at Baghdad Teaching Hospital, Medical City, Baghdad, Iraq, during the period January 1988 through to January 2001, we carried out 30 cases of restoractive proctocolectomy with ileal reservoir. At the beginning we used the S pouch (3 cases), then the J pouch (8 cases), finally we shifted to the extended J pouch (19 cases) with improved results.

RESULTS: Our surgical technique and the pre-operative and post-operative care improved, with more cases of restorative proctocolectomy with ileal reservoir carried out in our center. This is associated with a good progress in the functional results and a decrease in the early and late complications of the procedure.

CONCLUSION: Restorative proctocolectomy with ileal reservoir is a major surgical procedure with many early and late complications, but if it is carried out in expert hands with careful selection of the patients it will give good results.