This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS

Ileal pouch–anal anastomosis. BJS 2007; 94: 812-823.

Published: 15th June 2007

Authors: B. B. McGuire, A. E. Brannigan, P. R. O'Connell

Background

Since 1977, restorative proctocolectomy with ileoanal anastomosis (IAA) has evolved into the surgical treatment of choice for most patients with intractable ulcerative colitis. Construction of an ileal pouch reservoir is now standard, usually in the form of a $fontss=cmss10 scaled 1000 hbox{J}$
pouch (IPAA). The aim of this report is to review selection criteria for, and functional outcomes, follow‐up and management of complications of IPAA after 30 years of widespread clinical application.

Conclusion

The functional results of IPAA are good. Pouchitis, irritable pouch syndrome and cuffitis are specific long‐term complications but rarely result in failure. Pouch salvage is possible in selected patients with poor functional outcomes. One‐stage operations are increasingly performed. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

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