Journal
WORLD JOURNAL OF GASTROENTEROLOGY
Volume 20, Issue 37, Pages 13211-13218Publisher
BAISHIDENG PUBLISHING GROUP INC
DOI: 10.3748/wjg.v20.i37.13211
Keywords
Ulcerative colitis; Ileorectal anastomosis; Ileal pouch-anal anastomosis; Retained rectum; Neoplastic degeneration
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Total proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the current gold standard in the surgical treatment of ulcerative colitis (UC) refractory to medical management. A procedure of significant magnitude carries its own risks including anastomotic failure, pelvic sepsis and a low rate of neoplastic degeneration overtime. Recent studies have shown that total colectomy with ileorectal anastomosis (IRA) has been associated with good long-term functional results in a selected group of UC patients amenable to undergo a strict surveillance for the relatively high risk of cancer in the rectum. This manuscript will review and compare the most recent literature on IRA and IPAA as it pertains to postoperative morbidity and mortality, failure rates, functional outcomes and cancer risk. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.
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