The pathology of the ileal reservoir

Abstract

Restorative proctocolectomy with ileal reservoir is a surgical procedure of increasing importance [1]. The operation is undertaken in patients with diffuse mucosal disease of the large intestine: most patients have ulcerative colitis whilst a small percentage of operations are performed on patients with familial adenomatous polyposis (FAP). The pathological features discussed in this article are based on a study of 160 patients who have undergone restorative proctocolectomy with ileal reservoir at St. Mark’s Hospital, London. All of these patients are under rigorous follow-up and sigmoidoscopic biopsies of the reservoir mucosa are taken at least once a year. Some of the findings described in this paper relate to a smaller cohort of patients, 92 in number, who were extensively investigated in a systematic functional and pathological study [2, 3].