Results at up to 20 years after ileal pouch-anal anastomosis for chronic ulcerative colitis.

Détails

ID Serval
serval:BIB_3EB0B5EE6184
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Results at up to 20 years after ileal pouch-anal anastomosis for chronic ulcerative colitis.
Périodique
British Journal of Surgery
Auteur(s)
Hahnloser D., Pemberton J.H., Wolff B.G., Larson D.R., Crownhart B.S., Dozois R.R.
ISSN
0007-1323 (Print)
ISSN-L
0007-1323
Statut éditorial
Publié
Date de publication
2007
Volume
94
Numéro
3
Pages
333-340
Langue
anglais
Notes
Publication types: Evaluation Studies ; Journal ArticlePublication Status: ppublish
Résumé
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.
Mots-clé
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
Création de la notice
07/10/2014 15:11
Dernière modification de la notice
03/03/2018 16:23
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