Document Detail


Septic complications after restorative proctocolectomy do not impair functional outcome: long-term follow-up from a specialty center.
MedLine Citation:
PMID:  18584247     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: After restorative proctocolectomy, 7 to 8 percent of patients may have a pouch leak. Concern exists that pouch leak may be associated with impaired functional outcome. We evaluated patients who underwent restorative proctocolectomy to determine whether pouch leak adversely affected long-term functional outcome and quality of life. METHODS: We queried our prospectively maintained database of patients who underwent restorative proctocolectomy for demographic and clinical data. We sent a long-term outcome questionnaire to patients, including the validated Fecal Incontinence Severity Index and Cleveland Global Quality of Life scores. Pouch leak was identified by clinical or radiographic evidence of leak. Patients with leak were compared with those without to determine the impact on long-term functional outcome or quality of life. RESULTS: A total of 817 patients were available for follow-up and 374 patients (46 percent) completed questionnaires. The group with (n = 60; 16 percent) and without (n = 314; 84 percent) leak had similar demographics. The median Fecal Incontinence Severity Index score (15.3 vs. 14.7, P = 0.77), Cleveland Global Quality of Life score (0.79 vs. 0.81, P = 0.48), and bowel movements per 24 hours (7.92 vs. 7.88, P = 0.92) were similar. The pouch loss/permanent ileostomy rate was higher in those who leaked (13.3 vs. 0.9 percent, P < 0.001). CONCLUSIONS: Anastomotic leak after restorative proctocolectomy does not adversely affect long-term quality of life or functional outcome. However, pouch loss/permanent ileostomy is significantly more likely in patients who have had an anastomotic leak.
Authors:
David B Chessin; Stephen R Gorfine; David S Bub; Aaron Royston; Deborah Wong; Joel J Bauer
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Publication Detail:
Type:  Journal Article     Date:  2008-06-27
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  51     ISSN:  1530-0358     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-18     Completed Date:  2008-09-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1312-7     Citation Subset:  IM    
Affiliation:
Department of Surgery, Division of Colorectal Surgery, Mount Sinai Medical Center, New York, New York, USA. david.chessin@mssm.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Anastomosis, Surgical
Colectomy
Fecal Incontinence
Female
Follow-Up Studies
Humans
Ileostomy
Male
Outcome Assessment (Health Care)*
Proctocolectomy, Restorative / adverse effects*
Prospective Studies
Quality of Life*
Questionnaires
Sepsis / etiology*

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


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