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Wiesław Nowobilski, Marcin Folwarski and Marek Dobosz

References Parks AG, Nicholls RJ : Proctocolectomy without ileostomy for ulcerative colitis. BMJ 1978; 2: 85-88. Peters WR : Laparoscopic total proctocolectomy with creation of ileostomy for ulcerative colitis: report of two cases. J Laparoendosc Surg 1992 Jun; 2(3): 175-78. Wexner SD, Johansen OB, Nogueras JJ : Laparoscopic total abdominal colectomy. A prospective trial. Dis Colon Rectum 1992 Jul; 35(7): 651-55. Thibault C, Poulin EC : Total

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Jacek Hermann, Marta Sękowska and Michał Drews

References Williams NS : Restorative proctocolectomy is the first choice elective surgical treatment for ulcerative colitis. Br J Surg 1989; 76: 1109-10. Galandiuk S, Scott NA, Dozois RR et al.: Ileal pouch-anal anastomosis. Ann Surg 1990; 212(4): 446-52. Kelly KA, Pemberton JH, Wolff BG et al.: Ileal pouch-anal anastomosis. Curr Probl Surg 1992; 29(2): 61-131. Allan RN, Rhodes JM, Hanauer SB et al.: Inflammatory bowel diseases. Churchill

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Robert Burdyński, Tomasz Banasiewicz, Ryszard Marciniak, Maciej Biczysko, Jacek Szmeja, Jacek Paszkowski, Marcin Grochowalski, Jakub Maik, Przemysław Majewski, Piotr Krokowicz and Michał Drews

life. Am J Surg 2010 Jul; 200(1): 68-72. Banasiewicz T, Marciniak R, Kaczmarek E , et al.: The diameter of the ileal J-pouch-anal anastomosis as an important risk factor of pouchitis - clinical observations. Med Sci Monit (w druku). Scarpa M, van Koperen PJ, Ubbink DT , et al.: Systematic review of dysplasia after restorative proctocolectomy for ulcerative colitis. Br J Surg 2007; 94: 534-45. Naik VS, Patil SB, Scholefield J , et al.: Adenocarcinoma arising in a background of chronic

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Wiktor Bednarz, Robert Olewiński and Jerzy Woldan

References Michelassi F, Hurst R : Restorative proctocolectomy with J-pouch-ileo-anal anastomosis. Arch Surg 2000; 135: 347-53. Roberts PL : Surgical options for ulcerative colitis. Ann Chir Gynaecol 2000; 89: 257-61. Drews M, Krokowicz P, Meissner W : Restorative proctocolectomy and ileal pouch in surgical treatment of ulcerative colitis. Zentrabl Chir 1998; 123(suppl): 45-52. Yu Sch, Pemberton JH, Larson D : Ileal pouch anal anastomosis in patients

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Gjorgji Jota, Zoran Karadžov, Milčo Panovski, Nenad Joksimović, Andrijan Kartalov, Radomir Gelevski and Vladimir Joksimović

References Parks AG, Nicholls RJ. Proctocolectomy without ileostomy for ulcerative colitis. Br Med J 1978;2:85-8. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1605901/pdf/brmedj00134-0015.pdf [PUBMED] Fazio VW, Ziv Y, Church JM, Oakley JR, Lavery IC, Milsom JW, Schroeder TK: Ileal Pouch-Anal Anastomoses Complications and Function in 1005 Patients. Ann Surg 1995;222:120-7. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1234769/pdf/annsurg00042-0026.pdf [PUBMED] Shen B, Lashner B

Open access

Bartosz Wnęk, Marcin Strugała, Aleksandra Łożyńska-Nelke, Robert Burdyński and Piotr Krokowicz

-600. 4. Bisgaard ML, Fenger K, Bülow S et al.: Familial adenomatous polyposis (FAP): frequency, penetrance, and mutation rate. Hum Mutat 1994; 3 (2): 121-25. 5. Plawski A, Slomski R: The APC gene mutations causing FAP in Polish patients. J Applied Genetics 2008; 49 (4): 407-14. 6. Parks AG, Nicholls RJ et al.: Proctocolectomy without ileostomy for ulcerative colitis. Br Med J 1978; 2: 85-88. 7. Fazio VW, Ziv Y, Church JM et al.: Ileal pouchanal anastomoses complications and function in 1005 patients. Ann Surg 1995 Aug

Open access

Wiktor Meissner, Waldemar Szabłoński, Piotr Krokowicz, Iwona Ignyś, Jacek Szmeja and Michał Drews

(12): 1439-47. Dodero P, Magillo P, Scarsi PL et al.: Total colectomy and straight ileo-anal Soave endorectal pullthrough: personal experience with 42 cases. Eur J Paediatr Surg 2001; 11(5): 319-23. Fonkalsrud EW, Thakur A, Beanes S et al.: Ileoanal pouch procedures in children. J Paediatr Surg 2001; 36(11): 1689-92. Rintala RJ, Lindahl HG : Proctocolectomy and J-pouch ileo-anal anastomosis in children. J Paediatr Surg 2002; 37(1): 66-70. Wierzbicki T, Herman J

Open access

Andrzej Rutkowski, Maciej Chwaliński, Leszek Zajâc, Zbigniew Nowecki and Marek Nowacki

Risk of Permanent Stoma After Resection of Rectal Cancer Depending on the Distance Between the Tumour Lower Edge and Anal Verge

The distance between the anal verge and lower edge of rectal cancer is one of the most important factors affecting the feasibility of sphincter-preserving resection.

The aim of the study was to assess the risk of permanent stoma after resection of rectal tumour depending on the distance between the tumour and the anal verge.

Material and methods. The retrospective analysis covered 884 patients after resection of rectal cancer. The distance between the anal verge and the lowest edge of the tumour was measured during endoscopic examination. Surgical technique was similar in all cases. For statistical analysis, the chi-square test and Fisher exact test were used.

Results. The overall rate of sphincter-preserving procedures was 71.8%, 90.1% of which were anterior resections. The greatest differences between the rate of anterior resections were noted for the segment between the 4th and the 5th centimetres: 30.1% for 4 cm vs 66.7% for 5 cm, p = 0.005. Overall, in 328 patients (37.1%) surgical treatment resulted in a permanent stoma. The number included: 246 (75.0%) patients after abdominosacral resection, 44 (13.4%) patients after the Hartmann procedure, three (0.9%) patients after proctocolectomy, and 28 (8.5%) patients after anterior resection, with a permanent stoma as a result of anastomotic leak. The overall rate of anastomotic leak was 11.7%. Formation of a defunctioning stoma in patients with a low-lying (6 cm from the anal verge) tumour reduced the risk of symptomatic anastomotic leak: 6.3% vs 20.5%; p = 0.049.

Conclusions. Anterior resection of tumours located 6 cm from the anal verge is feasible in 90%. Anastomotic leak that requires reoperation increases the risk of permanent colostomy. In selected cases, formation of a defunctioning stoma after resection of low-lying rectal cancer can reduce the risk of permanent colostomy.

Open access

Tiberius Viorel Mogos, Claudia Valeria Chelan, Carmen Ionela Dondoi, Andra Evelin Iacobini and Mihaela Buzea

References 1. Messaris E, Sehgal R, Deiling S et al. Dehydration is the most common indication for readmission after diverting ileostomy creation. Dis Colon Rectum 55: 175-180, 2012. 2. Pironi L, Miglioli M, Ruggeri E et al. Nutritional status of patients undergoing ileal pouch-anal anastomosis. Clin Nutr 10: 292-297, 1991. 3. Buckman SA, Heise CP. Nutrition considerations surrounding restorative proctocolectomy. Nutr Clin Pract 25: 250-256, 2010. 4. Mogoș VT, Alimentatia in bolile de nutritie si

Open access

Tomasz Zieliński, Piotr Czyżewski and Marek Szczepkowski

-anal anastomosis. Int J Colorectal Dis 2006; 21(8): 767-73. 16. Saigusa N, Belin BM, Choi HJ et al.: Recovery of the rectoanal inhibitory reflex after restorative proctocolectomy: does it correlate with nocturnal continence? Dis Colon Rectum 2003; 46: 168-72. 17. Sudoł-Szopińska I, Szczepkowski M, Jakubowski W, Panorska A : Przydatność endosonografii u osób z wytworzonym odbytem brzusznym przed decyzją o wykonaniu operacji odtwórczej. Pol Merk Lek 2002; XIII; 78: 484-86.