Document Detail

Pouch design and long-term functional outcome after ileal pouch-anal anastomosis.
MedLine Citation:
PMID:  19358173     Owner:  NLM     Status:  MEDLINE    
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.
M Block; L Börjesson; E Lindholm; T Oresland
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The British journal of surgery     Volume:  96     ISSN:  1365-2168     ISO Abbreviation:  Br J Surg     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-14     Completed Date:  2009-04-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372553     Medline TA:  Br J Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  527-32     Citation Subset:  AIM; IM    
Copyright Information:
2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Department of Surgery, Sahlgrenska University Hospital/Ostra, Gothenburg, Sweden.
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MeSH Terms
Anal Canal / surgery*
Anastomosis, Surgical
Colonic Diseases / physiopathology,  surgery*
Colonic Pouches / physiology*
Defecation / physiology
Fecal Incontinence / etiology
Middle Aged
Postoperative Complications / etiology
Prosthesis Design
Surgical Stapling*
Suture Techniques*
Treatment Outcome
Young Adult

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