Quality of life ten and more years after restorative proctocolectomy for patients with familial adenomatous polyposis coli.

Abstract

PURPOSE:

Few studies on long-term quality of life after restorative proctocolectomy and ileal pouch-anal anastomosis have been published. Most of them survey a mixed patient population of familial adenomatous polyposis and ulcerative colitis. The present study analyzes long-term results more than 10 years after ileal pouch-anal anastomosis for patients with familial adenomatous polyposis, exclusively.

METHODS:

One hundred thirty-five patients who underwent ileal pouch-anal anastomosis more than 10 years ago were identified from the prospective familial adenomatous polyposis registry at Heidelberg University hospital. They received the German version of the health-specific Short Form 36 Health Survey and the disease-specific Gastrointestinal Quality of Life Index by mail. To assess the impact of disease-specific factors, 10 questions asking for ability to work, current medication, pouchitis, and extracolonic manifestations of familial adenomatous polyposis were added to the Gastrointestinal Quality of Life Index questionnaire.

RESULTS:

Among 84 patients who answered the questionnaires the median follow-up was 13.4 years (range, 10.3-23.8 y).The results of the Short Form 36 Health Survey were comparable to a German normative population in all dimensions, whereas the overall score for the Gastrointestinal Quality of Life Index was significantly reduced compared with healthy individuals (111.8 vs 120.8, P = .0014). Carcinoma at the time of ileal pouch-anal anastomosis, desmoid tumors, or duodenal adenomas had no significant influence on quality of life. More than 7 bowel movements during the daytime were found to reduce quality of life significantly (103.5 vs 115, P = .0127). More than 2 defecations per night diminished the score further (101 vs 125, P < .0001). Patients younger than 40 years at the time of ileal pouch-anal anastomosis had significantly better results than older patients (120 vs 109.5, P = .0076).

CONCLUSION:

Ileal pouch-anal anastomosis is a safe surgical procedure with a high quality of life comparable to that of a normative population after long-term follow-up of patients with familial adenomatous polyposis.

• Authors: Petra Ganschow, Ulrike Pfeiffer, Ulf Hinz, Christine Leowardi, Christian Herfarth, Martina Kadmon
• Journal: Diseases of the colon and rectum (Dis Colon Rectum) Vol. 53 Issue 10 Pg. 1381-7 (Oct 2010) ISSN: 1530-0358 [Electronic] United States
• PMID: 20847619 (Publication Type: Journal Article)

Topics

• Adenomatous Polyposis Coli (complications, pathology, surgery)
• Adolescent
• Adult
• Child
• Colonic Pouches
• Female
• Follow-Up Studies
• Health Surveys
• Humans
• Male
• Middle Aged
• Proctocolectomy, Restorative
• Quality of Life
• Time Factors
• Treatment Outcome
• Young Adult