Concepts in Surgery of the Large Intestine

  • Danny M. Takanishi
  • Fabrizio Michelassi


This chapter provides a comprehensive overview of essential concepts relating to the operative approach and strategy for colon and rectal surgery. Additional information is contained in the technical chapters that follow and the references at the end of the chapter.


Rectal Cancer Ulcerative Colitis Transanal Endoscopic Microsurgery Primary Anastomosis Loop Ileostomy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Roberts PL, Veidenheimer MC. Current management of diverticulitis. Adv Surg 1994;27:189.PubMedGoogle Scholar
  2. 2.
    Ferzoco LB, Raptopoulos V, Silen W. Acute diverticulitis. N Engl J Med 1998;338:1521.PubMedCrossRefGoogle Scholar
  3. 3.
    Smith TR, Cho KC, Morehouse HT, et al. Comparison of computed tomography and contrast enema evaluation of diverticulitis. Dis Colon Rectum 1990; 33:1.PubMedCrossRefGoogle Scholar
  4. 4.
    Schecter S, Mulvey J, Eisenstat TE. Management of uncomplicated acute diverticulitis: results of a survey. Dis Colon Rectum 1999;42:470.CrossRefGoogle Scholar
  5. 5.
    Eusebio EB, Eisenberg MM. Natural history of diverticular disease of the colon in young patients. Am J Surg 1973;125:308.PubMedCrossRefGoogle Scholar
  6. 6.
    Parker BM, Obeid FN, Sorensen VJ, et al. The management of massive lower gastrointestinal bleeding. Am Surg 1993;9:676.Google Scholar
  7. 7.
    Ballantyne GH, Brandner MD, Beart RW Jr, et al. Volvulus of the colon: incidence and mortality. Ann Surg 1985;202:83.PubMedCrossRefGoogle Scholar
  8. 8.
    Bower TC, Ischemic colitis. Surg Clin North Am 1993;73:1037.PubMedGoogle Scholar
  9. 9.
    Gandhi SK, Hanson MM, Vernava AM, et al. Ischemic colitis. Dis Colon Rectum 1996;39:88.PubMedCrossRefGoogle Scholar
  10. 10.
    Kim DS, Tsang CBS, Wong WD, et al. Complete rectal prolapse: evolution of management and results. Dis Colon Rectum 1999;42:460.PubMedCrossRefGoogle Scholar
  11. 11.
    Madoff RD, Mellgren A. One hundred years of rectal prolapse surgery. Dis Colon Rectum 1999;42:441.PubMedCrossRefGoogle Scholar
  12. 12.
    Altemeier WA, Culbertson WR, Schowengerdt C, et al. Nineteen years experience with the one-stage perineal repair of rectal prolapse. Ann Surg 1971;173: 993.PubMedCrossRefGoogle Scholar
  13. 13.
    Kinzler KW, Nilbert MC, Su L-K et al. Identification of FAP locus genes from chromosome 5q21. Science 1991;253:661.PubMedCrossRefGoogle Scholar
  14. 14.
    Kartheuser AN, Parc R, Penna CP, et al. Ileal pouchanal anastomosis as the first choice operation in patients with familial adenomatous polyposis: a ten year experience. Surgery 1996;119:615.PubMedCrossRefGoogle Scholar
  15. 15.
    Michelassi F. Indications for surgical treatment in ulcerative colitis and Crohn’s disease. In Michelassi F, Milsom JW (eds) Operative Strategies in Inflammatory Bowel Disease. New York, Springer-Verlag, 1999, pp 150–153.Google Scholar
  16. 16.
    Heppell J, Farkouh E, Dube S, et al. Toxic megacolon: an analysis of 70 cases. Dis Colon Rectum 1986;29: 789.PubMedCrossRefGoogle Scholar
  17. 17.
    McLeod RS. Resection margins and recurrent Crohn’s disease. Hepatogastroenterology 1990;37:63.PubMedGoogle Scholar
  18. 18.
    Heimann TM, Greenstein AJ, Lewis B, et al. Prediction of early symptomatic recurrence after intestinal resection in Crohn’s disease. Ann Surg 1993;218:294.PubMedCrossRefGoogle Scholar
  19. 19.
    Farouk R, Pemberton JH. Surgical options in ulcerative colitis. Surg Clin North Am 1997;77:85.PubMedCrossRefGoogle Scholar
  20. 20.
    Milsom JW. Restorative proctocolectomy with ileoanal anastomosis. In Michelassi F, Milsom JW (eds) Operative Strategies in Inflammatory Bowel Disease. New York, Springer-Verlag, 1999, pp 173–183.Google Scholar
  21. 21.
    Gemlo BT, Wong WD, Rothenberger DA, et al. Ileal pouch-anal anastomosis: patterns of failure. Arch Surg 1992;127:784.PubMedGoogle Scholar
  22. 22.
    Fazio VW, Ziv Y, Church JM, et al. Ileal pouch-anal anastomoses complications and function in 1005 patients. Ann Surg 1995;222:120.PubMedCrossRefGoogle Scholar
  23. 23.
    Miller R, Bartolo DC, Orrom WJ, et al. Improvement of anal sensation with preservation of the anal transition zone after ileoanal anastomosis for ulcerative colitis. Dis Colon Rectum 1990;33:414.PubMedCrossRefGoogle Scholar
  24. 24.
    McIntyre PB, Pemberton JH, Beart RW, et al. Doublestapled vs. hand-sewn ileal pouch-anal anastomosis in patients with chronic ulcerative colitis. Dis Colon Rectum 1994;37:430.PubMedCrossRefGoogle Scholar
  25. 25.
    Luukkonen P, Jarvinen HJ. Stapled vs. hand-sutured ileoanal anastomosis in restorative proctocolectomy: a prospective, randomized study. Arch Surg 1993; 128:437.PubMedGoogle Scholar
  26. 26.
    Gozzetti G, Poggioli G, Marchetti F, et al. Functional outcome in hand-sewn vs. stapled ileal pouch-anal anastomosis. Am J Surg 1994;168:325.PubMedCrossRefGoogle Scholar
  27. 27.
    Khubchandani IT, Kontostolis SB. Outcome of ileorectal anastomosis in an inflammatory bowel disease surgery experience of three decades. Arch Surg 1994;129:866.PubMedGoogle Scholar
  28. 28.
    Longo WE, Oakley JR, Laverly IC, et al. Outcome of ileorectal anastomosis for Crohn’s colitis. Dis Colon Rectum 1992;35:1066.PubMedCrossRefGoogle Scholar
  29. 29.
    Ekbom, A, Helmick C, Zack M, et al. Ulcerative colitis and colorectal cancer: a population-based study. N Engl J Med 1990;323:1228.PubMedGoogle Scholar
  30. 30.
    Pinczowski D, Ekbom A, Baron J, et al. Risk factors for colorectal cancer in patients with ulcerative colitis: a case-control study. Gastroenterology 1994; 107:117.PubMedGoogle Scholar
  31. 31.
    Taylor BA, Pemberton JH, Carpenter HA, et al. Dysplasia in chronic ulcerative colitis: implications for colonoscopic surveillance. Dis Colon Rectum 1992; 35:950.PubMedCrossRefGoogle Scholar
  32. 32.
    Ziv Y, Fazio VW, Church JM, et al. Safety of urgent restorative proctocolectomy with ileal pouch-anal anastomosis for fulminant colitis. Dis Colon Rectum 1995;38:345.PubMedCrossRefGoogle Scholar
  33. 33.
    Price AB. Overlap in the spectrum of nonspecific inflammatory bowel disease — “colitis indeterminate”. J Clin Pathol 1978;31:567.PubMedCrossRefGoogle Scholar
  34. 34.
    McIntyre PB, Pemberton JH, Wolff BG, et al. Indeterminate colitis: long-term outcome in patients after ileal pouch-anal anastomosis. Dis Colon Rectum 1995;38:51.PubMedCrossRefGoogle Scholar
  35. 35.
    Stein BL, Coller JA. Management of malignant colorectal polyps. Surg Clin North Am 1993;73:47.PubMedGoogle Scholar
  36. 36.
    Cooper HS, Deppisch LM, Gourly WK, et al. Endoscopically removed malignant colorectal polyps: clinicopathologic correlations. Gastroenterology 1995; 108:1657.PubMedCrossRefGoogle Scholar
  37. 37.
    Haggitt RC, Glotzbach RE, Soffer EE, et al. Prognostic factors in colorectal carcinomas arising in adenomas: implications for lesions removed by endoscopic polypectomy. Gastroenterology 1985;89:328.PubMedGoogle Scholar
  38. 38.
    Nivatvongs S, Rojanasakul A, Reiman HM, et al. The risk of lymph node metastases in colorectal polyps with invasive adenocarcinoma. Dis Colon Rectum 1991;34:323.PubMedCrossRefGoogle Scholar
  39. 39.
    Laverly IC, Lopez-Kostner F, Pelley RJ, et al. Treatment of colon and rectal cancer. Surg Clin North Am 2000;80:535.CrossRefGoogle Scholar
  40. 40.
    Hautefeuille P, Valleur P, Perniceni T. Functional and oncologic results after coloanal anastomosis for low rectal carcinoma. Ann Surg 1988;207:61.PubMedCrossRefGoogle Scholar
  41. 41.
    Bat L, Neumann G, Shemesh E. The association of synchronous neoplasm with occluding colorectal cancer. Dis Colon Rectum 1985;28:149.PubMedCrossRefGoogle Scholar
  42. 42.
    Kahn H, Alexander A, Rakinic J, et al. Preoperative staging of irradiated rectal cancers using digital rectal examination, computed tomography, endorectal ultrasound, and magnetic resonance imaging does not accurately predict T0,N0 pathology. Dis Colon Rectum 1997;40:140.PubMedCrossRefGoogle Scholar
  43. 43.
    Fisher B, Wolmark N, Rockette H, et al. Postoperative adjuvant chemotherapy or radiation therapy for rectal cancer: results from the NSABP protocol R-01. J Natl Cancer Inst 1988;90:21.CrossRefGoogle Scholar
  44. 44.
    Jessup JM, Bothe A, Stone MD, et al. Preservation of sphincter function in rectal carcinoma by a multimodality treatment approach. Surg Oncol Clin North Am 1992;1:137.Google Scholar
  45. 45.
    Papillon J, Gerard JP. Role of radiotherapy in anal preservation for cancer of the lower third of the rectum. Int J Radiat Oncol Biol Phys 1990;19:1219.PubMedGoogle Scholar
  46. 46.
    Minsky BD, Cohen AM, Enker WE, et al. Combined modality therapy of rectal cancer: decreased acute toxicity with the preoperative approach. J Clin Oncol 1992;10:1218.PubMedGoogle Scholar
  47. 47.
    Hyams DM, Mamounas EP, Petrelli N, et al. A clinical trial to evaluate the worth of preoperative multimodality therapy in patients with operable carcinoma of the rectum: a progress report of the national surgical breast and bowel project protocol r-03. Dis Colon Rectum 1997;40:131.PubMedCrossRefGoogle Scholar
  48. 48.
    Bernini A, Deen KI, Madoff RD, et al. Preoperative adjuvant radiation with chemotherapy for rectal cancer: its impact on stage of disease and the role of endorectal ultrasound. Ann Surg Oncol 1996;3:131.PubMedCrossRefGoogle Scholar
  49. 49.
    Shumate CR, Rich TA, Skibber JM, et al. Preoperative chemotherapy and radiation therapy for locally advanced primary and recurrent rectal carcinoma. A report of surgical morbidity. Cancer 1993;71:3690.PubMedCrossRefGoogle Scholar
  50. 50.
    Minsky BD. Sphincter preservation in rectal cancer. Preoperative radiation therapy followed by low anterior resection with coloanal anastomosis. Semin Radiat Oncol 1998;8:30.PubMedCrossRefGoogle Scholar
  51. 51.
    Mendenhall WM, Bland KI, Copeland EM III, et al. Does preoperative radiation therapy enhance the probability of local control and survival in high-risk distal rectal cancer? Ann Surg 1992;215:696.PubMedCrossRefGoogle Scholar
  52. 52.
    Vauthey JN, Marsh RW, Zlotecki RA, et al. Recent advances in the treatment and outcome of locally advanced rectal cancer. Ann Surg 1999;229:745.PubMedCrossRefGoogle Scholar
  53. 53.
    Wagman R, Minsky BD, Cohen AM, et al. Sphincter preservation in rectal cancer with preoperative radiation therapy and coloanal anastomosis: long term follow-up. Int J Radiat Oncol Biol Phys 1998;42:51.PubMedGoogle Scholar
  54. 54.
    Francois Y, Nemoz CJ, Baulieux J, et al. Influence of the interval between preoperative radiation therapy and surgery on downstaging and on the rate of sphincter-sparing surgery for rectal cancer: the Lyon R90-01 randomized trial. J Clin Oncol 1999;17: 2396.PubMedGoogle Scholar
  55. 55.
    Cho CC, Taylor CW III, Padmanabhan A, et al. Squamous cell carcinoma of the anal canal: management with combined chemoradiation therapy. Dis Colon Rectum 1991;34:675.PubMedCrossRefGoogle Scholar
  56. 56.
    Nigro ND. The force of change in the management of squamous-cell cancer of the anal canal. Dis Colon Rectum 1991;34:482.PubMedCrossRefGoogle Scholar
  57. 57.
    Franklin M, Rosenthal D, Abrego-Medina D, et al. Prospective comparison of open vs. laparoscopic colon surgery for carcinoma. Dis Colon Rectum 1996;39(suppl):35.CrossRefGoogle Scholar
  58. 58.
    Milsom J, Bohm B, Hammermofer K, et al. A prospective, randomized trial comparing laparoscopic versus conventional techniques in colorectal cancer surgery: a preliminary report. J Am Coll Surg 1998; 187:46.PubMedCrossRefGoogle Scholar
  59. 59.
    Philips EH, Franklin M, Caroll BJ, et al. Laparoscopic colectomy. Ann Surg 1992;216:703.CrossRefGoogle Scholar
  60. 60.
    Puente I, Sosa JL, Sleeman D, et al. Laparoscopicassisted colorectal surgery. J Laparoendosc Surg 1994; 4:1.PubMedGoogle Scholar
  61. 61.
    Stage J, Schulze S, Moller P, et al. Prospective randomized study of laparoscopic versus open colonic resection for adenocarcinoma. Br J Surg 1997;84:391.PubMedCrossRefGoogle Scholar
  62. 62.
    Talac R, Nelson H. Laparoscopic colon and rectal surgery. Surg Clin North Am 2000;9:1.Google Scholar
  63. 63.
    Eijsbouts QAJ, Heuff G, Sietses C, et al. Laparoscopic surgery in the treatment of colonic polyps. Br J Surg 1999;86:505.PubMedCrossRefGoogle Scholar
  64. 64.
    Larach SW, Patankar SK, Ferrara A, et al. Complications of laparoscopic colorectal surgery: analysis and comparison of early vs. latter experience. Dis Colon Rectum 1997;40:592.PubMedCrossRefGoogle Scholar
  65. 65.
    Kockerling F, Schneider C, Reymond MA, et al. Early results of a prospective multicenter study on 500 consecutive cases of laparoscopic colorectal surgery: laparoscopic colorectal surgery study group. Surg Endosc 1998;12:37.PubMedCrossRefGoogle Scholar
  66. 66.
    Franklin ME Jr, Dorman JP, Jacobs M, et al. Is laparoscopic surgery applicable to complicated colonic diverticular disease? Surg Endosc 1997;11:1021.PubMedCrossRefGoogle Scholar
  67. 67.
    Muckleroy SK, Ratzer ER, Fenoglio ME. Laparoscopic colon surgery for benign disease: a comparison to open surgery. J Soc Laparoendosc Surg 1999;3:33.Google Scholar
  68. 68.
    Sardinha TC, Wexner SD. Laparoscopy for inflammatory bowel disease: pros and cons. World J Surg 1998;22:370.PubMedCrossRefGoogle Scholar
  69. 69.
    Heintz A, Morschel M, Jumginger T. Comparison of results after transanal endoscopic microsurgery and radical resection for T1 carcinoma of the rectum. Surg Endosc 1998;12:1145.PubMedCrossRefGoogle Scholar
  70. 70.
    Saclarides TJ. Transanal endoscopic microsurgery: a single surgeon’s experience. Arch Surg 1998;133: 595.PubMedCrossRefGoogle Scholar
  71. 71.
    Winde G, Nottberg H, Keller R, et al. Surgical cure for early rectal carcinomas (T1): transanal endoscopic microsurgery vs. anterior resection. Dis Colon Rectum 1996;39:969.PubMedCrossRefGoogle Scholar
  72. 72.
    Kreis ME, Jehle EC, Haug V, et al. Functional results after transanal endoscopic microsurgery. Dis Colon Rectum 1996;39:1116.PubMedCrossRefGoogle Scholar
  73. 73.
    Smith LE, Ko ST, Saclarides T, et al. Transanal endoscopic microsurgery: initial registry results. Dis Colon Rectum 1996;39(suppl):79.CrossRefGoogle Scholar
  74. 74.
    Salvati EP, Rubin RJ, Eisenstat TE, et al. Electrocoagulation of selected carcinoma of the rectum. Surg Gynecol Obstet 1988;166:393.PubMedGoogle Scholar
  75. 75.
    Papillon J. Intracavitary irradiation of early rectal cancer for cure: a series of 186 cases. Dis Colon Rectum 1994;37:88.PubMedCrossRefGoogle Scholar
  76. 76.
    Papillon J. Surgical adjuvant therapy for rectal cancer: present options. Dis Colon Rectum 1994;37:144.PubMedCrossRefGoogle Scholar
  77. 77.
    Turnbull RB, et al. Cancer of the colon: the influence of the no-touch isolation technique on survival rates. Ann Surg 1967;166:420.PubMedCrossRefGoogle Scholar
  78. 78.
    Lau PW, Lo CY, Law WL. The role of one stage surgery in acute left-sided colonic obstruction. Am J Surg 1995;169:406.PubMedCrossRefGoogle Scholar
  79. 79.
    MacKenzie S, Thomson SR, Baker LW. Management options in malignant obstruction of the left colon. Surg Gynecol Obstet 1992;174:337.PubMedGoogle Scholar
  80. 80.
    Naraynsingh V, Rampayl R, Maharaj D, et al. Prospective study of primary anastomosis without colonic lavage for patients with an obstructed left colon. Br J Surg 1999;86:1341.PubMedCrossRefGoogle Scholar
  81. 81.
    Nyam DCNK, Seow Choen F, Leong AFPK, et al. Colonic decompression without on-table irrigation for obstructing left-sided colorectal tumours. Br J Surg 1996;83:786.PubMedCrossRefGoogle Scholar
  82. 82.
    Forloni B, Reduzzi R, Paludetti A, et al. Intraoperative colonic lavage in emergency surgical treatment of left-sided colonic obstruction. Dis Colon Rectum 1998;41:23.PubMedCrossRefGoogle Scholar
  83. 83.
    Kressner U, Autonsson J, Ejerblad S, et al. Intraoperative colonic lavage and primary anastomosis and alternative to Hartmann procedure in emergency surgery of the left colon. Eur J Surg 1994;160:287.PubMedGoogle Scholar
  84. 84.
    Murray JJ, Schoetz DJ, Coller JA, et al. Intraoperative colonic lavage and primary anastomosis in nonelective colon resection. Dis Colon Rectum 1991;34:527.PubMedCrossRefGoogle Scholar
  85. 85.
    Rey JF, Romanczyk MG. Metal stents for palliation of rectal carcinoma: a preliminary report on 12 patients. Endoscopy 1995;27:501.PubMedCrossRefGoogle Scholar
  86. 86.
    Saida Y, Sumiyama Y, Nagao J, et al. Stent endopros-thesis for obstructing colorectal cancers. Dis Colon Rectum 1996;39:552.PubMedCrossRefGoogle Scholar
  87. 87.
    Mainar A, DeGregorio Ariza MA, Tejero E, et al. Acute colorectal obstruction: treatment with self-expandable metallic stent scheduled surgery: results of a multicenter study. Radiology 1999;210:65.PubMedGoogle Scholar
  88. 88.
    Binkert CA, Ledermann H, Jost R, et al. Acute colonic obstruction: clinical aspects and cost-effectiveness of preoperative palliative treatment with self-expanding metallic stents: a preliminary report. Radiology 1998; 206:199.PubMedGoogle Scholar
  89. 89.
    Akle CA. Endoprostheses for colonic strictures. Br J Surg 1998;85:310.PubMedCrossRefGoogle Scholar
  90. 90.
    O’Leary DP. Use of the greater omentum in colorectal surgery. Dis Colon Rectum 1999;42:533.PubMedCrossRefGoogle Scholar
  91. 91.
    Del Rio JV, Beck DE, Opelka FG. Chronic perioperative steroids and colonic anastomosis healing in rats. J Surg Res 1996;66:138.PubMedCrossRefGoogle Scholar
  92. 92.
    Eubanks TR, Greenberg JJ, Dobrin PB, et al. The effects of different corticosteroids on the healing colonic anastomosis and cecum in a rat model. Am Surg 1997;63:266.PubMedGoogle Scholar
  93. 93.
    Furst MB, Stromber BV, Blatchford GJ, et al. Colonic anastomoses: bursting strength after corticosteroid treatment. Dis Colon Rectum 1994;37:12.PubMedCrossRefGoogle Scholar
  94. 94.
    Ziv Y, Church JM, Fazio VW, et al. Effect of systemic steroids on ileal pouch-anal anastomosis in patients with ulcerative colitis. Dis Colon Rectum 1996;39: 504.PubMedCrossRefGoogle Scholar
  95. 95.
    Cali RL, Ssmyrk TC, Blatchford GJ, et al. Effect of prostaglandin E1 and steroid on healing colonic anastomoses. Dis Colon Rectum 1993;36:1148.PubMedCrossRefGoogle Scholar
  96. 96.
    Ruiz PL, Facciuto EM, Facciuto ME, et al. New intraluminal bypass tube for management of acutely obstructed left colon. Dis Colon Rectum 1995;38: 1108.PubMedCrossRefGoogle Scholar
  97. 97.
    Yoon WH, Song IS, Chang ES. Intraluminal bypass technique using a condom for protection of coloanal anastomosis. Dis Colon Rectum 1994;37:1046.PubMedCrossRefGoogle Scholar
  98. 98.
    Michelassi F, Takanishi D, McLeod RS, et al. Ileal reservoirs. In Michelassi F, Milsom JW (eds) Operative Strategies in Inflammatory Bowel Disease. New York, Springer-Verlag, 1999, pp 186–214.Google Scholar
  99. 99.
    Joo JS, Latulippe JF, Alabaz O, et al. Long-term functional evaluation of straight coloanal anastomosis and colonic J-pouch: is the functional superiority of colonic J-pouch sustained? Dis Colon Rectum 1998; 41:740.PubMedCrossRefGoogle Scholar
  100. 100.
    Dehni N, Tiret E, Singland JD, et al. Long-term functional outcome after low anterior resection: comparison of low colorectal anastomosis and colonic J-pouch-anal anastomosis. Dis Colon Rectum 1998;41: 817.PubMedCrossRefGoogle Scholar
  101. 101.
    Read TE, Kodner IJ. Protectomy and coloanal anastomosis for rectal cancer. Arch Surg 1999;134:670.PubMedCrossRefGoogle Scholar
  102. 102.
    Shellito PC. Complications of abdominal stoma surgery. Dis Colon Rectum 1998;41:1562.PubMedCrossRefGoogle Scholar
  103. 103.
    Feinberg SM, McLeod RS, Cohen Z. Complications of loop ileostomy. Am J Surg 1987;153:102.PubMedCrossRefGoogle Scholar
  104. 104.
    Bass EM, Del Pino A, Tan A, et al. Does preoperative stoma marking and education by the enterostomal therapist affect outcome? Dis Colon Rectum 1997; 40:440.PubMedCrossRefGoogle Scholar
  105. 105.
    Parks SE, Hastings PR. Complications of colostomy closure. Am J Surg 1985;149:672.PubMedCrossRefGoogle Scholar
  106. 106.
    Hull TL, Kobe I, Fazio VW. Comparison of handsewn with stapled loop ileostomy closures. Dis Colon Rectum 1996;39:1086.PubMedCrossRefGoogle Scholar
  107. 107.
    Reissman P, Teoh TA, Cohen SM, et al. Is early oral feeding safe after elective colorectal surgery? A prospective randomized trial. Ann Surg 1995;222:73.PubMedCrossRefGoogle Scholar
  108. 108.
    Nessim A, Wexner SD, Agachan F, et al. Is bowel confinement necessary after anorectal reconstructive surgery? A prospective randomized, surgeonblinded trial. Dis Colon Rectum 1999;42:16.PubMedCrossRefGoogle Scholar
  109. 109.
    Kehlet H, Mogensen T. Hospital stay of 2 days after open sigmoidectomy with a multimodal rehabilitation programme. Br J Surg 1999;86:227.PubMedCrossRefGoogle Scholar
  110. 110.
    Mignon M, Stettler C, Phillips SF. Pouchitis—a poorly understood entity. Dis Colon Rectum 1995;38:100.PubMedCrossRefGoogle Scholar
  111. 111.
    Stahlberg D, Gullberg K, Liljeqvist L, et al. Pouchitis following pelvic pouch operation for ulcerative colitis: incidence, cumulative risk, and risk factors. Dis Colon Rectum 1996;39:1012.PubMedCrossRefGoogle Scholar
  112. 112.
    Hurst RD, Molinari M, Chung TP, et al. Prospective study of the incidence, timing, and treatment of pouchitis in 104 consecutive patients after restorative proctocolectomy. Arch Surg 1996;131:497.PubMedGoogle Scholar
  113. 113.
    Nicholls RJ, Banerjee AK. Pouchitis: risk factors, etiology, and treatment. World J Surg 1998;22:347.PubMedCrossRefGoogle Scholar
  114. 114.
    Keranen U, Luukkonen P, Jarvinen H. Functional results after restorative proctocolectomy complicated by pouchitis. Dis Colon Rectum 1997;40:764.PubMedCrossRefGoogle Scholar
  115. 115.
    Sandborn WJ, McLeod R, Jewell DP. Medical therapy for induction and maintenance of remission in pouchitis: a systematic review. Inflamm Bowel Dis 1999; 5:33.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2006

Authors and Affiliations

  • Danny M. Takanishi
    • 1
  • Fabrizio Michelassi
    • 1
  1. 1.Department of Surgery The University of ChicagoThe Pritzker School of MedicineChicagoUSA

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