On November 2014, Dr. Joel Bauer made two presentations at the Society of Pelvic Surgeons Annual Meeting in Tampa, Florida. He was invited to participate in the Presidential Panel on achieving continence after urinary organ or colonic removal. As a panelist, he presented a history of intestinal stomas from the 1900’s to the present, including some personal published reports on achieving continence for colostomies and ileostomies.
He also presented his experience with restorative proctocolectomy (RPC) and ileal pouch-anal anastomosis from data gathered from an expansive prospective practice database of patients who underwent the procedure. Of 1,067 patients undergoing RPC with ileoanal anastomosis in the practice database, 193 had either cancer or dysplasia or both in their resection specimens. The focus of this presentation was on the follow-up of patients who had only dysplasia in the rectum (29) or in the colon (77) or in the colon and rectum (51). The long-term survival of patients with dysplasia in the rectum was similar to that of patients with dysplasia in the colon in the follow-up period. Both populations had a disease-free survival rate of approximately 98%. There was no significant difference in the recurrence rate in those patients with rectal dysplasia as compared to those with colonic dysplasia. As per this study, restorative proctocolectomy with rectal mucosectomy and ileal pouch-anal anastomosis seems to be an acceptable alternative for these patients.