Management of Ovarian Cysts in Women Undergoing Resorative Proctoclectomy for Ulcerative Colitis

Thakur, Anjani; Buchmiller-Crair, Terry; Fonkalsrud, Eric W.; Yang, Isaac; Lin, Albert
April 2003
American Surgeon;
More than half of all patients undergoing restorative proctocolectomy (RP) for ulcerative colitis (UC) are women, yet there is a paucity of information regarding the frequency, management, and outcome of ovarian cysts. A single surgeon's (E.W.F.) experience with female patients (N = 165) who underwent RP for UC at an academic medical center was retrospectively evaluated for postoperative complications and overall outcome. Patients with large ovarian cysts (LOCs), defined as being greater than 5 cm in diameter, were further segregated for subanalysis. All results were analyzed using the Student's t test and Fisher's exact test. Patients were 29.3 ± 13 years (mean) at the time of RP; 34 patients were less than 16 years old (21%), 113 patients (68%) were between the ages of 17 and 46 years, and 18 patients were over 46 years old (11%). All patients underwent total colectomy, mucosal proctectomy ileal pouch-anal anastomosis, and temporary end ileostomy. The ileostomy was closed 3 months later. Fifty-five of the 165 patients had ovarian cysts (33%) identified at operation, 46 had unilateral cysts, and nine had bilateral cysts. Mean ovarian cyst size was 4.6 ± 2.7 cm (range <1-13 cm); 14 were LOCs. Patients with cysts <3 cm in diameter at operation were treated by observation with hormonal manipulation. Seventeen patients with cysts 3 to 5 cm in diameter required partial resection of one or both ovaries. Six of 14 patients with LOC underwent unilateral oophorectomy (cyst size range 10-13 cm). Twelve patients presented within 3 years after RP with malfunction of the pouch because of adhesions or minimal and uncontrolled passage of fecal material (soiling), partial obstruction due to LOC compression of the ileoanal pouch (n = 6), or adhesions. When evaluated on the basis of ovarian cyst size those without cysts and those with small cysts were significantly more likely to have children than those with LOC: 54 of 110 patients without cysts (49%), 18 of the...


Related Articles

  • Manometric study in ulcerative colitis patients with modified ileal pouch–anal anastomosis. Kobakov, Georgi; Kostov, Daniel; Temelkov, Temelko // International Journal of Colorectal Disease;Dec2006, Vol. 21 Issue 8, p767 

    Sphincter-saving operations and construction of intestinal reservoirs aim at additional improvement quality of life of patients with restorative proctocolectomy. The conventional ileoanal anastomosis affects the function of the anal sphincters. There is a need for operative techniques that...

  • Ileal pouch-anal anastomosis (IPAA): functional outcome after postoperative pelvic sepsis. Hallberg, Helena; Ståhlberg, Dagny; Åkerlund, Jan-Erik // International Journal of Colorectal Disease;Nov2005, Vol. 20 Issue 6, p529 

    Introduction: The ileal pouch-anal anastomosis (IPAA) has become a standard procedure for patients with ulcerative colitis requiring surgical intervention. The technique has greatly improved and, since 1990, all patients at Huddinge University Hospital have been operated on with the double...

  • Laparoscopic restorative proctocolectomy for ulcerative colitis. Kessler, H.; Hohenberger, W. // Surgical Endoscopy;Jan2006, Vol. 20 Issue 1, p166 

    Background: With increasing experience, laparoscopic techniques have been applied even to extended colorectal operations as restorative proctocolectomy for ulcerative colitis and familial adenomatous polyposis [1–10]. Methods: A 36-year-old woman with a 7-year history of ulcerative...

  • Late-onset fistula presenting as buttock abscess in two patients with ileo-anal J-pouches for ulcerative colitis. Banerjee, S.; Farquharson, M.; Cecil, T. D.; Gold, D.; Moran, B. J. // Techniques in Coloproctology;Mar2004, Vol. 8 Issue 1, p37 

    Two cases are described of patients who presented with a buttock abscess 3 and 5 years after restorative proctocolectomy for ulcerative colitis. In both the abscess was secondary to a fistula, which was shown on further investigation to be a track traversing the greater sciatic notch. Both...

  • Laparoscopic total proctocolectomy with ileal pouch anal anastomosis for ulcerative colitis and familial adenomatous polyposis: initial experience in Mexico. López-Rosales, F.; González-Contreras, Q.; Muro, L.; Berber, M.; León, H.; Fernández, O.; Veana, R.; López-Rosales, F; González-Contreras, Q; Muro, L J; Berber, M M; de León, H T Cid; Fernández, O V; Veana, R R // Surgical Endoscopy;Dec2007, Vol. 21 Issue 12, p2304 

    Background: Since the introduction of laparoscopic colectomy in 1991, experience in laparoscopic bowel surgery has gradually increased. Several reports from specialized centers have demonstrated that laparoscopic colorectal resections are feasible and safe, providing an acceptable...

  • Pathogenesis of and Unifying Hypothesis for Idiopathic Pouchitis. Coffey, J. Calvin; Rowan, Fiachra; Burke, John; Dochery, Neil; Kirwan, William O.; O'Connell, P. Ronan // American Journal of Gastroenterology;Apr2009, Vol. 104 Issue 4, p1013 

    Ileal pouch-anal anastomosis is the procedure of choice in the surgical management of refractory ulcerative colitis. Pouchitis affects up to 60% of patients following ileal pouch-anal anastomosis for ulcerative colitis. It overlaps significantly with ulcerative colitis such that improvements in...

  • Stapled ileoanal pouches without loop ileostomy: a prospective study in 86 patients. Gullberg, Kjell; Liljeqvist, Lars // International Journal of Colorectal Disease;Jul2001, Vol. 16 Issue 4, p221 

    In restorative proctocolectomy the use of a stapling technique to construct an ileal pouch with anal anastomosis offers an alternative to the hand-sewn technique following mucosectomy; a temporary defunctioning loop ileostomy may reduce the consequences of an anastomotic leakage, however it may...

  • Quality of life after ileoanal pouch: a comparison of J and W pouches. Wade, Alexander D.; Mathiason, Michelle A.; Brekke, Eric F.; Kothari, Shanu N. // Journal of Gastrointestinal Surgery;Jul2009, Vol. 13 Issue 7, p1260 

    Introduction: Standard treatment for ulcerative colitis and prevention of malignancy is total proctocolectomy with a neoileal pouch. The ideal configuration of the pouch has been debated. We hypothesized that there was no difference in quality of life between the J pouch and the W...

  • Clinical Features of Refractory Pouchitis with Penetrating Lesions and the Efficacy of Infliximab Treatment for Patients with Ulcerative Colitis after Restorative Proctocolectomy. Uchino, Motoi; Ikeuchi, Hiroki; Bando, Toshihiro; Hirose, Kei; Hirata, akihiro; Chohno, Teruhiro; Sasaki, Hirofumi; Horio, Yuki; Takahashi, Yoshiko; Takesue, Yoshio; Hida, Nobuyuki; Hori, Kazutoshi; Nakamura, Shiro // Digestion;Oct2015, Vol. 92 Issue 3, p147 

    Background: Chronic pouchitis with penetrating anal lesions often leads to pouch failure after restorative proctocolectomy. The aim of this study was to analyze those predictors and to evaluate the effects of infliximab (IFX). Methods: We reviewed patients' backgrounds and performed a...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics