| Pouch design and long-term functional outcome after ileal pouch-anal anastomosis. | |
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MedLine Citation:
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PMID: 19358173 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Functional outcome is of utmost importance after ileal pouch-anal anastomosis. Although pouch design and construction of the anastomosis are known technical determinants of function, there are few long-term results. This retrospective study evaluated functional outcome for two different pouch designs, and for handsewn versus stapled pouch-anal anastomoses. METHODS: The analysis included 412 patients who had either a J or K pouch (double-folded J pouch), of whom 123 had a J pouch (96 handsewn and 27 stapled) and 289 had a K pouch (95 handsewn and 194 stapled). Functional outcome was evaluated by a mailed questionnaire to achieve an Oresland score (0 to 15; 15 worst). RESULTS: Mean functional scores were 6.1 for J pouches and 4.9 for K pouches (P < 0.001). Regression analysis showed that reservoir design and age at surgery were predictors of functional outcome (P < 0.001). A higher proportion of patients with a J pouch and handsewn anastomosis than with a K pouch and stapled anastomosis had a score of 8 or more, a level previously demonstrated to impact negatively on quality of life (32 versus 16 per cent; P = 0.006). CONCLUSION: The K pouch was associated with a better long-term functional outcome than the J pouch in this patient population. |
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Authors:
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M Block; L Börjesson; E Lindholm; T Oresland |
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Publication Detail:
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Type: Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The British journal of surgery Volume: 96 ISSN: 1365-2168 ISO Abbreviation: Br J Surg Publication Date: 2009 May |
Date Detail:
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Created Date: 2009-04-14 Completed Date: 2009-04-24 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372553 Medline TA: Br J Surg Country: England |
Other Details:
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Languages: eng Pagination: 527-32 Citation Subset: AIM; IM |
Copyright Information:
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2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. |
Affiliation:
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Department of Surgery, Sahlgrenska University Hospital/Ostra, Gothenburg, Sweden. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Anal Canal / surgery* Anastomosis, Surgical Colonic Diseases / physiopathology, surgery* Colonic Pouches / physiology* Defecation / physiology Fecal Incontinence / etiology Female Humans Male Middle Aged Postoperative Complications / etiology Prosthesis Design Surgical Stapling* Suture Techniques* Treatment Outcome Young Adult |
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