{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T16:17:39Z","timestamp":1778516259244,"version":"3.51.4"},"reference-count":21,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,3,27]],"date-time":"2013-03-27T00:00:00Z","timestamp":1364342400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2013,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Whether bowel related dysfunction adversely affects postoperative recovery after total colectomy with ileorectal anastomosis (<jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>\u00a0+\u00a0<jats:styled-content style=\"fixed-case\">IRA<\/jats:styled-content>) for colonic inertia (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) has not been previously well evaluated. This study compared the early postoperative outcome of <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>\u00a0+\u00a0<jats:styled-content style=\"fixed-case\">IRA<\/jats:styled-content> for <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> and for other noninflammatory indications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Patients undergoing elective <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>\u00a0+\u00a0<jats:styled-content style=\"fixed-case\">IRA<\/jats:styled-content> from 1999 to 2010 were identified from a prospectively maintained database. Since inflammation in the rectum or small bowel may influence the outcome, patients with inflammatory bowel disease were excluded. Patients undergoing surgery for <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> (group <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>) were compared with patients having the operation for other benign noninflammatory diseases (group <jats:styled-content style=\"fixed-case\">B<\/jats:styled-content>). Demographics, <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>merican <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>ociety of <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>nesthesiologists (<jats:styled-content style=\"fixed-case\">ASA<\/jats:styled-content>) score, body mass index (<jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>), surgical procedure and 30\u2010day complications were assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study population consisted of 333 patients undergoing elective <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>\u00a0+\u00a0<jats:styled-content style=\"fixed-case\">IRA<\/jats:styled-content> (99 men, mean age 39\u00a0\u00b1\u00a016\u00a0years). The procedure was laparoscopic in 163 (49%) patients. Groups <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content> (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>131) and <jats:styled-content style=\"fixed-case\">B<\/jats:styled-content> (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>202) had similar age and <jats:styled-content style=\"fixed-case\">ASA<\/jats:styled-content> score (39\u00a0\u00b1\u00a011 <jats:italic>vs<\/jats:italic> 39\u00a0\u00b1 19\u00a0years, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.4; 2.2\u00a0\u00b1\u00a00.5 <jats:italic>vs<\/jats:italic> 2.4\u00a0\u00b1\u00a00.7). Group <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content> patients had lower <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> (25\u00a0\u00b1\u00a05 <jats:italic>vs<\/jats:italic> 28\u00a0\u00b1\u00a08\u00a0kg\/m<jats:sup>2<\/jats:sup>, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.002), more women (99 <jats:italic>vs<\/jats:italic> 51%, <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.001) and fewer laparoscopic procedures (43 <jats:italic>vs<\/jats:italic> 53%, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.04). Compared with group <jats:styled-content style=\"fixed-case\">B<\/jats:styled-content>, group <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content> had a greater incidence of postoperative ileus (32 <jats:italic>vs<\/jats:italic> 19%, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.009), higher overall morbidity (36 <jats:italic>vs<\/jats:italic> 15%, <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.001) and increased length of stay (8.4\u00a0\u00b1\u00a06 <jats:italic>vs<\/jats:italic> 7.2\u00a0\u00b1\u00a05\u00a0days, <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.006). These differences persisted when subgroups of patients who underwent laparoscopic or open surgery were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Although <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> is considered a \u2018benign\u2019 condition, patients undergoing <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>\u00a0+\u00a0<jats:styled-content style=\"fixed-case\">IRA<\/jats:styled-content> for this indication have significant morbidity compared with patients having the operation for other noninflammatory benign conditions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.12058","type":"journal-article","created":{"date-parts":[[2012,10,12]],"date-time":"2012-10-12T17:36:19Z","timestamp":1350063379000},"page":"481-486","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Colectomy with ileorectal anastomosis has a worse 30\u2010day outcome when performed for colonic inertia than for a neoplastic indication"],"prefix":"10.1111","volume":"15","author":[{"given":"A.","family":"Reshef","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery Digestive Disease Institute Cleveland Clinic Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Gurland","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Digestive Disease Institute Cleveland Clinic Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Zutshi","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Digestive Disease Institute Cleveland Clinic Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. 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