Dr Böhm and colleagues from Germany reviewed the outcome of patients who had undergone subtotal colectomy for ulcerative colitis with formation of a rectal stump.
The research team specifically investigated the fate of the rectal stump in patients undergoing emergency colectomy vs urgent or elective resection.
The team reported that a total of 31 patients underwent subtotal colectomy for ulcerative colitis between 1990 and 2000.
Patients were identified using the computerized coding system for the years 1995 to 2000.
The research team also accessed pathology records, discharge letters, and operation notes.
|85% attempting ileal pouch-anal anastomosis had success|
|International Journal of Colorectal Diseases|
The team undertook postal and telephone surveys using a standard questionnaire assessing social, physical, sexual, and bowel activities of patients.
The researchers found that follow-up was complete in 28 out of 31 patients.
Of these, the researchers found that 86% underwent excision of rectal stump.
The team observed that 14% of patients preferred to undergo excision of the rectum only, resulting in a permanent ileostomy.
A further 71% of patients had attempted ileal pouch-anal anastomosis, with success observed in 85%.
In 14% of patients, the rectal stump remained in situ, and was associated with a decrease in the quality of life.
There were no perioperative deaths, and morbidity was low for all procedures.
Dr Böhm's team concludes, “These data show that after subtotal colectomy, the majority of our ulcerative colitis patients undergo ileal pouch-anal anastomosis.”
“Patients' satisfaction is high with reasonable social and excellent sexual function on quality of life assessment.”
“During its retention, the rectal stump causes considerable symptoms.”
“When left in situ, it is associated with a decrease in the quality of life.”