Dr Pascal Gervaz

Chirurgien FMH, chirurgie interne & chirurgie viscérale



The Effect of Diverticular Disease on the Colonic J Pouch




by da Silva GM, Kaiser R, Börjesson L, Colqhoun P, Lobo C, Khandwala F, Thornton J, Efron J, Vernava AM 3rd, Weiss EG, Wexner SD, Gervaz P, Nogueras JJ.






The aim of this study was to assess the impact of the diverticular disease (DD) on function and on postoperative complications of the colonic J-pouch (CJP) with pouch-anal anastomosis.



Patients who underwent a CJP between December 1990 and August 2001, were retrospectively reviewed. The presence of DD in the CJP was assessed on pouchogram prior to ileostomy closure. A questionnaire designed to evaluate the degree of continence (total incontinence score (IS): 0 = worst, 20 = best) and pouch evacuation (total evacuation score (ES): 0 = worst, 28 = best) was used for comparison between patients with DD and those without DD (NDD).



Sixty-six patients (47 males; 19 females) with a median age of 68 years (range 28-87 years) were included. The median follow-up period was 22 months (range 2-106 months). Twenty-four patients comprised the DD group and 42 were in the NDD group. The two groups were comparable for age, gender and time from ileostomy closure; all patients with postoperative chemoradiation therapy were in the NDD group. The total ES and IS total did not significantly differ between the two groups with a P-value of 0.11 and 0.09 respectively. Furthermore, there was no significant difference in the total incidence of pouch complications between the two groups (3 strictures, 1 leak, 1 fistula in the NDD group vs. 1 pelvic sepsis in the DD group; P = 0.4).



The presence of DD in a CJP does not seem to impact pouch function or the postoperative complication rate.

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in Colorectal Disease: The Official Journal of the Association of Coloproctology of Great Britain and Ireland 2004 May; 6(3): 171-5.