{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T15:47:14Z","timestamp":1648828034416},"reference-count":25,"publisher":"FapUNIFESP (SciELO)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Gastroenterol."],"published-print":{"date-parts":[[2008,9]]},"abstract":"<jats:p>RACIONAL: Retocolectomia total e reservat\u00f3rio ileal com anastomose ileoanal constitui o procedimento de escolha para doentes com retocolite ulcerativa inespec\u00edfica que requerem cirurgia. Entretanto, alguns doentes por ela acometidos podem desenvolver caracter\u00edsticas compat\u00edveis com doen\u00e7a de Crohn, com conseq\u00fcente fal\u00eancia do reservat\u00f3rio. OBJETIVO: Avaliar a evolu\u00e7\u00e3o tardia dos doentes com reservat\u00f3rios ileais cujo diagn\u00f3stico definitivo foi doen\u00e7a de Crohn. M\u00c9TODOS: Entre fevereiro de 1983 a mar\u00e7o de 2007, 151 doentes do Grupo de Coloproctologia do Hospital das Cl\u00ednicas da Universidade Estadual de Campinas, SP, foram submetidos a retocolectomia total e reservat\u00f3rio ileal, sendo 76 por retocolite ulcerativa inespec\u00edfica. Destes, 11 (14,5%) evolu\u00edram como doen\u00e7a de Crohn, com diagn\u00f3stico histopatol\u00f3gico confirmado em 9: 1 no esp\u00e9cime da retocolectomia, 2 na proctectomia, 2 em segmentos de intestino delgado, 3 em reservat\u00f3rios ileais, sendo 2 em biopsias e 1 no reservat\u00f3rio ressecado, e 1 em material de abscesso perianal. Oito doentes (72,7%) eram mulheres e a m\u00e9dia de idade foi de 30,6 (18-65) anos. RESULTADOS: Todos tinham diagn\u00f3stico pr\u00e9-operat\u00f3rio de retocolite ulcerativa inespec\u00edfica e cinco foram operados inicialmente por megac\u00f3lon t\u00f3xico. O tempo m\u00e9dio entre a confec\u00e7\u00e3o do reservat\u00f3rio ileal e a manifesta\u00e7\u00e3o da doen\u00e7a de Crohn foi de 30,6 meses. Ileostomia de prote\u00e7\u00e3o n\u00e3o foi fechada apenas em um doente que apresentou f\u00edstula do reservat\u00f3rio no enema opaco e, posteriormente, abscesso perianal extenso e recidiva da doen\u00e7a de Crohn na al\u00e7a aferente do reservat\u00f3rio. No seguimento tardio, tr\u00eas doentes evolu\u00edram com f\u00edstulas perianais e perineais complexas, sendo associada \u00e0 f\u00edstula reservat\u00f3rio-vaginal em uma delas. Todos necessitaram de nova deriva\u00e7\u00e3o e o reservat\u00f3rio foi excisado em um deles devido \u00e0 persist\u00eancia da sepse p\u00e9lvica. Uma outra apresentou f\u00edstula do reservat\u00f3rio para o intr\u00f3ito vaginal, corrigida com cirurgia de avan\u00e7o mucoso. Houve tamb\u00e9m progress\u00e3o da doen\u00e7a para o \u00edleo proximal em tr\u00eas doentes. Nos outros tr\u00eas, a recidiva da doen\u00e7a foi no reservat\u00f3rio ileal, com boa resposta ao tratamento cl\u00ednico. Atualmente, com seguimento m\u00e9dio de 76,5 meses, todos os doentes est\u00e3o assintom\u00e1ticos, sendo que quatro est\u00e3o com deriva\u00e7\u00e3o e sete com reservat\u00f3rios funcionantes, estes apresentando 6-10 evacua\u00e7\u00f5es ao dia e contin\u00eancia praticamente normal. CONCLUS\u00c3O: Recidiva da doen\u00e7a de Crohn ap\u00f3s retocolectomia e reservat\u00f3rio ileal \u00e9 relativamente freq\u00fcente, com ocorr\u00eancia de complica\u00e7\u00f5es como abscessos, f\u00edstulas e estenoses. Entretanto, reservat\u00f3rios ileais com doen\u00e7a de Crohn e mantidos, podem ser compat\u00edveis com fun\u00e7\u00e3o satisfat\u00f3ria.<\/jats:p>","DOI":"10.1590\/s0004-28032008000300007","type":"journal-article","created":{"date-parts":[[2010,1,7]],"date-time":"2010-01-07T10:06:30Z","timestamp":1262858790000},"page":"204-207","source":"Crossref","is-referenced-by-count":0,"title":["Resultados da cirurgia de reservat\u00f3rios ileais em pacientes com doen\u00e7a de Crohn"],"prefix":"10.1590","volume":"45","author":[{"given":"Maria de Lourdes Setsuko","family":"Ayrizono","sequence":"first","affiliation":[{"name":"Universidade Estadual de Campinas,  SP"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luciana Rodrigues","family":"Meirelles","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas,  SP"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raquel Franco","family":"Leal","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas,  SP"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cl\u00e1udio Saddy Rodrigues","family":"Coy","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas,  SP"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jo\u00e3o Jos\u00e9","family":"Fagundes","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas,  SP"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juvenal Ricardo Navarro","family":"G\u00f3es","sequence":"additional","affiliation":[{"name":"Universidade Estadual de Campinas,  SP"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","reference":[{"key":"ref1","first-page":"590","article-title":"Ileoproctostomy is preferred over ileoanal pull-through in patients with indeterminate colitis","volume":"61","author":"Bodzin JH","year":"1995","journal-title":"Am 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