Harry E. Bacon Oration. Comparison of the functional results of restorative proctocolectomy for ulcerative colitis between the J and W configuration ileal pouches with sutured ileoanal anastomosis

Dis Colon Rectum. 1995 Jun;38(6):567-72. doi: 10.1007/BF02054113.

Abstract

Purpose: This study was designed to compare function of patients who had undergone reconstruction following proctocolectomy for ulcerative colitis using the J or W configuration ileoanal pouch.

Methods: Of 126 patients who underwent restorative proctocolectomy between January 1981 and March 1993, 101 had surgery for ulcerative colitis. Eighty-seven of these patients were available for review by personal or postal interview. All operative procedures were performed by one surgeon. The group comprised 35 W-pouches and 52 J-pouches.

Results: More patients with a J-pouch had a stool frequency of greater than 8 per 24 hours (P = 0.044), and they were also more likely to use a perineal pad (P = 0.019). No difference in the rates of nocturnal stool frequency, fecal incontinence, or use of constipating agents between the two pouch designs was found. Significantly more patients with a J-pouch have had episodes of pouchitis (P = 0.001). Of the total patient group 91.9 percent felt that restorative proctocolectomy had improved their quality of life.

Conclusion: Minor differences in the function of the W configuration ileoanal pouch and the J configuration ileoanal pouch are demonstrated in this study.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Colitis, Ulcerative / physiopathology
  • Colitis, Ulcerative / surgery*
  • Defecation
  • Fecal Incontinence / etiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Proctocolectomy, Restorative / adverse effects
  • Proctocolectomy, Restorative / methods*
  • Proctocolectomy, Restorative / mortality