Document Detail


Quality of life after ileoanal pouch: a comparison of J and W pouches.
MedLine Citation:
PMID:  19357929     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Standard treatment for ulcerative colitis and prevention of malignancy is total proctocolectomy with a neoileal pouch. The ideal configuration of the pouch has been debated. We hypothesized that there was no difference in quality of life between the J pouch and the W pouch. MATERIAL AND METHODS: We retrospectively reviewed the medical records of all patients undergoing ileoanal anastomosis with pouch construction at a single community-based teaching hospital over an 11+-year period. We collected demographic, operative, and postoperative data and then developed and distributed a survey designed to assess patient quality of life following pouch construction. The data of patients who had J pouches were then compared with those of patients who had W pouches. Forty-nine patients were identified; 30 had J pouches and 19 had W pouches. RESULTS: The groups did not differ significantly in age, sex, or indication for surgery. Significant differences were detected in readmission rates (J = 63%, W = 21%; p = 0.004) and length of follow-up (J = 61 months, W = 117 months; p = 0.001). Complication rates, length of stay, and conversion to end ileostomy rates were similar between groups. Self-reported health status, activity restrictions, urgency, seepage, protective pad use, and number of bowel movements at night were also similar. A significant difference existed in number of bowel movements per day (J = 6, W = 4.5, p = 0.041). No difference in quality of life was found between groups. Subgroup analysis of ulcerative-colitis-only patients had no effect on results. CONCLUSION: Because the J pouch is less technically demanding, it should be the preferred configuration.
Authors:
Alexander D Wade; Michelle A Mathiason; Eric F Brekke; Shanu N Kothari
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-04-09
Journal Detail:
Title:  Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract     Volume:  13     ISSN:  1873-4626     ISO Abbreviation:  J. Gastrointest. Surg.     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-06-09     Completed Date:  2009-09-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9706084     Medline TA:  J Gastrointest Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1260-5     Citation Subset:  IM    
Affiliation:
Department of Medical Education, Gundersen Lutheran Medical Foundation, 1900 South Avenue, C03-006B, La Crosse, WI 54601, USA.
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MeSH Terms
Descriptor/Qualifier:
Adaptation, Physiological
Adaptation, Psychological
Adolescent
Adult
Age Factors
Aged
Anastomosis, Surgical / adverse effects,  methods
Colitis, Ulcerative / pathology,  surgery
Colonic Neoplasms / pathology,  surgery
Colonic Pouches*
Defecation / physiology
Female
Follow-Up Studies
Humans
Length of Stay
Male
Middle Aged
Postoperative Complications / diagnosis,  surgery
Probability
Proctocolectomy, Restorative / methods*
Quality of Life*
Questionnaires
Reoperation
Retrospective Studies
Risk Assessment
Sex Factors
Sickness Impact Profile
Treatment Outcome
Young Adult

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


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