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Long-Term Followup with Evaluation of the Surgical and Functional Results of the Ileal Pouch Reservoir in Restorative Proctocolectomy for Ulcerative Colitis

By Ola Røkke, Knut Iversen, Torill Olsen, Sølvi-Mai Ristesund, Geir Egil Eide and Gitta Erika Turowski

Abstract

Aims. Evaluate the early and long term surgical and functional results of the ileal pouch-reservoir (IPAA) in patients with intractable ulcerative colitis. Material and Methods. Followup of 134 consecutive patients with W-or J-ileal pouch by diseases-specific and general health (SF-36) questionnaire. In the first 44 patients, early and late followup was performed. Results. Followup was performed 7.4 years (0.5–17 years) after construction of W (n = 9) and J (n = 125) ileal pouch, which had similar results. There were 14.9% early and 43.6% late complications with 12.7% early and 19.5% late reoperations. Protecting loop-ileostomy used in 54 patients (43.9%), did not protect against complications. Thirteen reservoirs (9.8%) were resected (n = 8) or deactivated (n = 5) due to functional failure. Operation time, postoperative complications and pouchitis were determinators for reservoir failure and reduced quality of life. The functional results at followup of 44 patients at 2.5 years (0.8–6.7 years) and 11.5 years (8.2–19.2 years) were remarkably similar. Conclusions. IPAA is a good option for most patients when medication fails. 10% experience failure with inferior quality of life. Protective stoma will not reduce failure rates. After an initial time period, reservoir function will not change over time

Topics: Clinical Study
Publisher: International Scholarly Research Network
OAI identifier: oai:pubmedcentral.nih.gov:3168493
Provided by: PubMed Central

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Citations

  1. (2004). c a r p a ,I .A n g r i m a n ,C .R u ffolo et al., “Health-related quality of life after restorative proctocolectomy for ulcerative colitis: long-term results,”
  2. (2002). C.W int er ,P .N eary ,A.M urph y ,H.P .R
  3. (2005). Ed., Colon & Rectal Surgery,
  4. (2002). Equivalent function, quality of life and pouch survival rates after ileal pouch-anal anastomosisfor indeterminate and ulcerative colitis,”
  5. (1966). Evaluation of survival data and two new rank order statistics arising in its consideration,”
  6. (1999). F a z i o ,M .G .O ’ R i o r d a i n ,I .C .L a v e r ye ta l . ,“ L o n g - t e r m functional outcome and quality of life after stapled restorative proctocolectomy,”
  7. (1995). F a z i o ,Y .Z i v ,J .M .C h u r c he ta l . ,“ I l e a lp o u c h - a n a l anastomoses complications and function
  8. (1998). Form36(SF-36)healthsurvey: normative data from the general Norwegian population,”
  9. (2003). G o r fi n e ,A .F i c h e r a ,M .T .H a r r i s ,a n dJ .J .B a u e r ,“ L o n g -term results of salvage surgery for septic complications after restorative proctocolectomy: does fecal diversion improve outcome?” Diseases of the Colon and Rectum,
  10. (1995). G o r fi n e ,I .M .G e l e r n t ,J .J .B a u e r ,M .T .H a r r i s ,a n d I. Kreel, “Restorative proctocolectomy without diverting ileostomy,” Diseases of the Colon and Rectum,
  11. (2005). H u e t i n g ,E .B u s k e n s ,I .T w e e l ,H .G .G o o s z e n ,a n dC .J . H. M.Laarhoven,“Results andcomplicationsafter ilealpouch anal anastomosis: a meta-analysis of 43 observational studies comprising 9,317 patients,” Digestive Surgery,
  12. (2000). Ileal pouch-anal anastomosisin patients with indeterminate colitis.
  13. (1980). Imajo et al., “Total colectomy, mucosal proctectomy, and ileoanal anastomosis,”
  14. (1983). Karl pearson and the chi-squared test,”
  15. (1958). Nonparametric estimation from incomplete observations,”
  16. (2001). One- or two-stage procedure for restorative proctocolectomy: rationale for a surgical strategy in ulcerative colitis,”
  17. (1978). Proctocolectomy without ileostomy for ulcerative colitis,”
  18. (1996). Prospective controlled trial of duplicated (J) versus quadruplicated, (W) pelvic ileal reservoirs in restorative proctocolectomy for ulcerative colitis,”
  19. (2000). Randomized, controlled trial to compare the J-pouch and W-pouch configurations for ulcerative colitis
  20. (2009). Recommended tests for association in 2×2t a b l e s ,
  21. (1972). Regression models and life tables (with discussion),” J o u r n a lo ft h eR o y a lS t a t i s t i c a lS o c i e t y ,S e r i e sB ,v o l
  22. (2005). Restorative proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis and familial adenomatous polyposis: twenty years follow-up
  23. (1985). Restorative proctocolectomy with ileal reservoir for ulcerative colitis and familial adenomatous polyposis: a comparison of three reservoir designs,”
  24. (1987). Restorative proctocolectomy: the four loop (W) reservoir,”
  25. (2007). Ten years experience of onestage restorative proctocolectomy for ulcerative colitis,”
  26. The MOS 36-item shortf o r mh e a l t hs u r v e y(
  27. (1908). The probable error of the mean,”
  28. (1992). The role of the defunctioning ileostomy in restorative proctocolectomy,”
  29. (1992). The W-reservoir: long-term assessment after proctocolectomy for ulcerative colitis and familial polyposis,”
  30. (1995). Wolff,R .R .D o z o i s