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Revista médica de Chile

versión impresa ISSN 0034-9887

Resumen

BELLOLIO R, Felipe et al. Ileorectal anastomosis in the surgical treatment of ulcerative colitis: Long-term results. Rev. méd. Chile [online]. 2008, vol.136, n.9, pp.1121-1126. ISSN 0034-9887.  http://dx.doi.org/10.4067/S0034-98872008000900005.

Background: Total colectomy with ileorectal anastomosis (IRA) is an alternative to the ileoanal pouch for the surgical treatment of ulcerative colitis in a selected group of patients. This technique leaves rectal mucosa Hable to develop persistent proctitis, dysplasia and cancer Aim: To describe short and long-term results of IRA and to assess the presence of dysplasia. Material and methods: Descriptive study of patients treated with IRA. The data were obtained from the clinical records, and the present status was evaluated with an interview. A proctoscopy and biopsy was offered free of cost to the contacted patients. Results: Between 1978 and 2005, 26 patients were operated. One patient presented an anastomotic leakage that was treated with a loop ileostomy There was no operative mortality. Twenty-three patients were followed for a períod of 1 to 23 years. Three patients evolved as Crohn 's disease and two of them needed a proctectomy. Three patients died of non-related diseases. In the remaining 17, the average evacuation rate was 3.7/24 h and all were continent. None developed a rectal cancer Only two patients had their planned annual endoscopic surveillance. In 2 of the 11 patients who accepted endoscopy and biopsy, a low-grade dysplasia was found. Conclusions: IRA has low morbidity and acceptable functional results in this selected group of patients. No patient present high-grade dysplasia or cancer; however, the adherence to the endoscopic follow-up ispoor.

Palabras clave : Colitis, ulcerative; Endoscopy, digestive system; Rectal neoplasms.

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