Long-term outcome 10 years or more after restorative proctocolectomy and ileal pouch-anal anastomosis in patients with ulcerative colitis.

Abstract

PURPOSE:

The aim of this study was to assess quality of life (QOL) in a long-term follow-up of patients with ulcerative colitis (UC) 10 years and more after ileal pouch-anal anastomosis (IPAA) to correlate these results with pouch function and to assess the long-term pouch failure rate.

METHODS:

In a unicentric study, 294 consecutive patients after IPAA between 1988 and 1996 were identified from a prospective database. QOL was evaluated according to the validated Gastrointestinal Quality of Life Index (GIQLI).

RESULTS:

Overall median follow-up was 11.5 years. Thirty-seven patients experienced pouch failure (12.6%). The rates of ileal pouch success after 5, 10 and 15 years were 92.3%, 88.7% and 84.5%. According to the GIQLI, patients with a functioning pouch achieved a mean score of 107.8, reflecting a decrease of QOL of 10.8% compared to a healthy population. There were significant negative correlations between QOL and an age of >50 years (p < 0.05), pouchitis, perianal inflammation and increased stool frequency (p < 0.0001).

CONCLUSIONS:

QOL and functional results of patients with UC 10 years or more after IPAA were acceptable; however, those were reduced when compared to a healthy population. Pouch failure rate still increases up to 15.5% 15 years after IPAA. This result represents an important issue in providing patients with comprehensive preoperative information.

• Authors: Christine Leowardi, Ulf Hinz, Mirjam Tariverdian, Peter Kienle, Christian Herfarth, Alexis Ulrich, Martina Kadmon
• Journal: Langenbeck's archives of surgery (Langenbecks Arch Surg) Vol. 395 Issue 1 Pg. 49-56 (Jan 2010) ISSN: 1435-2451 [Electronic] Germany
• PMID: 19280217 (Publication Type: Journal Article)

Topics

• Adult
• Age Factors
• Anal Canal (surgery)
• Anastomosis, Surgical (methods)
• Cohort Studies
• Colitis, Ulcerative (diagnosis, mortality, surgery)
• Colonic Pouches (adverse effects)
• Female
• Follow-Up Studies
• Humans
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Pouchitis (diagnosis, therapy)
• Probability
• Proctocolectomy, Restorative (adverse effects, methods, mortality)
• Quality of Life
• Retrospective Studies
• Risk Assessment
• Sex Factors
• Statistics, Nonparametric
• Surveys and Questionnaires
• Time Factors
• Treatment Outcome