Document Detail


Long-term outcome 10 years or more after restorative proctocolectomy and ileal pouch-anal anastomosis in patients with ulcerative colitis.
MedLine Citation:
PMID:  19280217     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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
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Publication Detail:
Type:  Journal Article     Date:  2009-03-12
Journal Detail:
Title:  Langenbeck's archives of surgery / Deutsche Gesellschaft f?r Chirurgie     Volume:  395     ISSN:  1435-2451     ISO Abbreviation:  Langenbecks Arch Surg     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2009-12-01     Completed Date:  2010-02-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9808285     Medline TA:  Langenbecks Arch Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  49-56     Citation Subset:  IM    
Affiliation:
Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany. Christine.Leowardi@med.uni-heidelberg.de
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MeSH Terms
Descriptor/Qualifier:
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-Meiers Estimate
Male
Middle Aged
Pouchitis / diagnosis,  therapy
Probability
Proctocolectomy, Restorative / adverse effects,  methods*,  mortality
Quality of Life*
Questionnaires
Retrospective Studies
Risk Assessment
Sex Factors
Statistics, Nonparametric
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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