Results at up to 20 years after ileal pouch-anal anastomosis for chronic ulcerative colitis.
Details
State: Public
Version: Final published version
License: Not specified
Serval ID
serval:BIB_3EB0B5EE6184
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Results at up to 20 years after ileal pouch-anal anastomosis for chronic ulcerative colitis.
Journal
British Journal of Surgery
ISSN
0007-1323 (Print)
ISSN-L
0007-1323
Publication state
Published
Issued date
2007
Peer-reviewed
Oui
Volume
94
Number
3
Pages
333-340
Language
english
Notes
Publication types: Evaluation Studies ; Journal ArticlePublication Status: ppublish
Abstract
BACKGROUND: Ileal pouch-anal anastomosis (IPAA) is performed routinely for chronic ulcerative colitis.
METHODS: Using data from a prospective database and annual standardized questionnaires, functional outcome, complications and quality of life (QoL) after IPAA were assessed.
RESULTS: Some 1885 IPAA operations were performed for chronic ulcerative colitis over a 20-year period (mean follow-up 11 years). The mean age at the time of IPAA was 34.1 years, increasing from 31.2 years (1981-1985) to 36.3 years (1996-2000). The overall rate of pouch success at 5, 10, 15 and 20 years was 96.3, 93.3, 92.4 and 92.1 per cent respectively. Mean daytime stool frequency increased from 5.7 at 1 year to 6.4 at 20 years (P < 0.001), and also increased at night (from 1.5 to 2.0; P < 0.001). The incidence of frequent daytime faecal incontinence increased from 5 to 11 per cent during the day (P < 0.001) and from 12 to 21 per cent at night (P < 0.001). QoL remained unchanged and 92 per cent remained in the same employment. Seventy-six patients were eventually diagnosed with indeterminate colitis and 47 with Crohn's disease.
CONCLUSION: IPAA is a reliable surgical procedure for patients requiring proctocolectomy for chronic ulcerative colitis and indeterminate colitis. The clinical and functional outcomes are excellent and stable for 20 years after operation.
METHODS: Using data from a prospective database and annual standardized questionnaires, functional outcome, complications and quality of life (QoL) after IPAA were assessed.
RESULTS: Some 1885 IPAA operations were performed for chronic ulcerative colitis over a 20-year period (mean follow-up 11 years). The mean age at the time of IPAA was 34.1 years, increasing from 31.2 years (1981-1985) to 36.3 years (1996-2000). The overall rate of pouch success at 5, 10, 15 and 20 years was 96.3, 93.3, 92.4 and 92.1 per cent respectively. Mean daytime stool frequency increased from 5.7 at 1 year to 6.4 at 20 years (P < 0.001), and also increased at night (from 1.5 to 2.0; P < 0.001). The incidence of frequent daytime faecal incontinence increased from 5 to 11 per cent during the day (P < 0.001) and from 12 to 21 per cent at night (P < 0.001). QoL remained unchanged and 92 per cent remained in the same employment. Seventy-six patients were eventually diagnosed with indeterminate colitis and 47 with Crohn's disease.
CONCLUSION: IPAA is a reliable surgical procedure for patients requiring proctocolectomy for chronic ulcerative colitis and indeterminate colitis. The clinical and functional outcomes are excellent and stable for 20 years after operation.
Keywords
Adolescent, Adult, Aged, Aged, 80 and over, Anal Canal/physiopathology, Anal Canal/surgery, Analysis of Variance, Anastomosis, Surgical, Child, Colitis, Ulcerative/physiopathology, Colitis, Ulcerative/surgery, Colonic Pouches/physiology, Colonic Pouches/standards, Fecal Incontinence/etiology, Fecal Incontinence/physiopathology, Female, Follow-Up Studies, Humans, Ileum/surgery, Male, Middle Aged, Postoperative Complications/etiology, Postoperative Complications/physiopathology, Proctocolectomy, Restorative/standards, Prospective Studies, Quality of Life, Time Factors, Treatment Outcome
Pubmed
Web of science
Open Access
Yes
Create date
07/10/2014 15:11
Last modification date
31/01/2022 13:43
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