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At least 721 records · Page 40Linked to original sources
PubMed1995

[Ulcerative rectocolitis: review of clinical characteristics in patients with distal colitis and extended colitis].

Ulcerative colitis is an inflammatory disease which, starting from the rectum, affects more or less extended tracts of the colon. Given that distal and extended forms are generally described as a single nosological entity, the authors aimed to verify whether there are any clinical differences between the two groups of patients with varying extents of disease. A retrospective review was made of data relating to 189 patients suffering from ulcerative colitis observed over a 90-months period. Only 111 cases were included in the study: all patients had undergone an endoscopic and histological diagnosis with a follow-up of over one year. Seventy-eight patients (41.26%) were excluded from the study because they had been lost during follow-up, or follow-up had lasted less than one year, or it had not been possible to perform pancolonoscopy. The 111 patients examined were subdivided into 2 groups: one (39 patients) with distal colitis, namely involving the rectum or recto-sigmoid, and the other (72 patients) with more extended disease. The extension of disease was evaluated on the basis of histological findings. The mean follow-up was 5 years and 11 months. The two groups were comparable for age, sex, number of annual attacks, maximum duration of disease-free periods, clinical evolution, predominant symptoms, extraintestinal symptoms and surgical treatment. Results were processed using Student's t test and the chi-square test.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Long-term results in ileo-anal reservoirs in the treatment of ulcero-hemorrhagic rectocolitis].

The authors report long term results of 53 ileo-anal anastomosis for ulcerative colitis. They used a "J" pouch technique with anastomosis to the anal canal after mucosectomy of the lower rectum. An upstream ileostomy should be created and left in place for two to three months. Early morbidity primarily involves pelvic or parietal infectious problems, while late complications comprise pelvic fistulae, obstructive events, and episodes of pouch inflammation. Functional results improve over the first year and remain stable thereafter. The major long term problem remains that of pouch inflammation its treatment, and the understanding of its pathophysiology.

Activities of Daily Living↗
PubMed1995

[Comparative randomized open study of the efficacy and tolerance of enemas with 2 gr of 4-amino-salicylic acid (4-ASA) and 1 gr of 5-amino-salicylic acid (5-ASA) in distal forms of hemorrhagic rectocolitis].

OBJECTIVES AND METHODS: The aim of this multicentre, randomized open trial was to compare the efficacy and tolerance of 4-ASA vs 5-ASA enemas in the treatment of distal moderately active ulcerative colitis. Fifty patients were randomized to receive enemas in 100 mL suspension of 4-ASA (2 g, n = 26), or 5-ASA (1 g, n = 24). The subjects filled a daily questionnaire on enema retention duration, and tolerance. Clinical and endoscopic evaluations were performed at baseline and after 2 and 4 weeks. RESULTS: Significant clinical and endoscopic improvements occurred in both groups. Efficacy and enema retention time did not differ between groups. Tolerance was significantly better for 4-ASA: score 0.46 +/- 0.77 vs 1.00 +/- 0.73, P = 0.03. CONCLUSIONS: Efficacy of both treatments was equivalent, but 4-ASA enemas were better tolerated than 5-ASA in this open trial.

Adult↗
PubMedDate not supplied

[Quality of life and ileo-anal anastomosis with pouch. Results of a prospective series of 35 surgically treated cases of hemorrhagic rectocolitis. Proposal for a score of quality of life].

Ileal-pouch anal anastomosis (IPAA) following coloproctectomy avoids permanent ileostomy, and allows complete excision of diseased mucosa in ulcerative colitis (UC) and adenomatous polyposis. Preserving normal intestinal pattern, the goal of IPAA is to improve quality of life for patients. This study was designed to measure the impact of IPAA on quality of life in a series of 35 surgically treated UC. Four fields of quality of life were explored: diet, professional activity, sport practice, sexual activity. Interview with independent observer and prospective follow-up allowed to establish a score from 0 (excellent quality of life) to 19 (bad quality of life). In the same time, functional score evaluating pouch evacuation and continence was established (0 = excellent function, 30 = bad function) to be compared to quality of life. The series included 35 IPAA in function for more than 6 months (mean follow-up = 46 +/- 31 months), performed for UC (14 females and 21 males, mean age: 34 y-a). Respectively 30 (86%) and 5 (14%) of the patients had an excellent and fair quality of life, according to the scoring system: 25 had no diet, all but one had a normal professional activity and all were satisfied of sport practice; 33 had no sexual disturbances related to IPAA, but 3 female patients complained of infertility. Functional results were excellent, fair and bad respectively in 25 (72%), 9 (26%) and 1 patients: stool frequency was 4.6 +/- 2 per day, 60% of patients having no nocturnal emission, and 90% being able to delay for more than 1 hour.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

[Dysplasia and colorectal neoplasms in a group of patients with ulcerative rectocolitis (URC)].

In our Medical Department we examined 74 patients with ulcerative colitis between January 1987 and December 1992. All the patients have been controlled by colonoscopy and multiple rectal byopsies. As started by different studies, the ulcerative colitis is predictive of mucosal dysplasia alterations and colo-rectal carcinoma. Our experience confirms that the occurrence is not so high as reported by some preliminary studies. These results could probably attributed to better diagnostic and therapeutic strategies now available.

Adult↗
PubMed1994

[Results of ileoanal anastomosis with mucosectomy and "J" pouch in hemorrhagic rectocolitis].

The aim of this study was to assess the results of ileal "J" pouch-anal anastomosis in ulcerative colitis. One hundred and fifty six patients operated on between 1983 and 1991 for ulcerative colitis were followed-up prospectively since the surgical procedure with a mean of 29 +/- 16 months (range: 6 to 92 months). There was no postoperative death. Forty-four patients (28%) presented 48 post-operative complications and 14 (9%) were reoperated. Twenty-five patients (16%) were reoperated because of a late complication. Three pouches had to be removed for untreatable fistulas which appeared to be related to a Crohn's disease in 2 cases; the reestablishment of a diverting loop ileostomy was mandatory in 2 further patients for anoperineal sepsis. The mean stool frequency at 1 year was 4.5 +/- 1.9; 40% of patients did not have nocturnal stooling. Daytime and nighttime continence were normal in 90.7% and 77.5% of cases respectively, 87% of patients considered their social life improved by the surgical cure of the disease. The results observed 5 years after the surgical procedure in 37 patients were similar to those observed at 1 year. Twenty-five patients (16%) presented one or several episodes of pouchitis, including 5 cases of chronic pouchitis. It is concluded that the treatment of ulcrerative colitis, ileal "J" pouch-anal anastomosis, is a safe and effective procedure which provides good functional results.

Adolescent↗
PubMed1994

[Ileo-anal anastomosis in hemorrhagic-ulcerative rectocolitis and familial adenomatous polyposis: is it mandatory to perform resection of the endo-anal mucosa?].

The aim of this study was to assess the clinical outcome after ileal pouch-anal anastomosis with mucosectomy for ulcerative colitis and for familial adenomatous polyposis, and to characterize the histology of the stripped endoanal mucosa with particular reference to the ulcerative colitis activity, adenomatous polyps and dysplasia. Twenty-eight patients were operated, 16 for ulcerative colitis (group I) and 12 for familial adenomatous polyposis (group II). In group I, there were no intraoperative complications, but mucosectomy was tedious in 10 patients (62%) and the anastomosis was performed under some degree of tension in 10 patients (62%). In group II, there was a direct injury of the internal sphincter by a posterior tear during the mucosal stripping in one case. Mucosectomy was easy to perform in 8 patients (67%) and 10 anastomoses (84%) were performed under tension. In both groups, there were no postoperative complications related to the mucosectomy or to the anastomosis itself. Functional results were good, with a normal continence in 80% of ulcerative colitis patients and 92% of familial adenomatous polyposis patients. Review of histological sections of the stripped anal mucosa in group I showed chronic active ulcerative colitis in 8 patients (50%), chronic non-active ulcerative colitis in 4 (25%) and quiescent ulcerative colitis in 4 (25%). There was only one case of moderate dysplasia in a patient with a Dukes A carcinoma. In group II, anal mucosa showed micropolyps in all cases with mild dysplasia in 3 cases (25%) and moderate dysplasia in 9 (75%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adenomatous Polyposis Coli↗