Ileal pouch-anal anastomosis for chronic ulcerative colitis. Long-term results

Ann Surg. 1987 Oct;206(4):504-13. doi: 10.1097/00000658-198710000-00011.


The aim of this study was to determine the long-term outcome among 390 patients with ulcerative colitis who underwent ileal J pouch-anal anastomosis and whether patient or operative factors influenced results. The combined operative morbidity rate for the pouch-anal anastomosis and the subsequent closure of the temporary ileostomy was 29% (bowel obstruction, 22%; pelvic sepsis, 5%), with one death due to pulmonary embolus. The probability of a successful outcome at 5 years was 94%. Of the 24 patients who failed (6% of total), 18 did so within 1 year (4%), three during year 2 (1%), three during year 3 (1%), and none thereafter. Stool frequency (7 stools/24 h), the occurrence of pouchitis (14%), and satisfactory daytime continence (94% of patients) remained stable over 4 years after operation, whereas nocturnal fecal spotting decreased (51% of patients to 20%). Women had more spotting than men, whereas patients over 50 years old had more stools per day than those 50 years or younger. In conclusion, ileal pouch-anal anastomosis achieved a reasonable stool frequency and satisfactory continence in patients with ulcerative colitis over the long-term. These results support the ileal pouch-anal anastomosis as a safe, satisfactory alternative to permanent ileostomy.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Anal Canal / surgery*
  • Anastomosis, Surgical / adverse effects
  • Anastomosis, Surgical / methods
  • Colitis, Ulcerative / complications
  • Colitis, Ulcerative / surgery*
  • Defecation
  • Fecal Incontinence / etiology
  • Female
  • Follow-Up Studies
  • Humans
  • Ileostomy
  • Ileum / surgery*
  • Male
  • Postoperative Complications
  • Sexual Behavior
  • Urination Disorders / etiology