[Quality of life and ileo-anal anastomosis with pouch. Results of a prospective series of 35 surgically treated cases of hemorrhagic rectocolitis. Proposal for a score of quality of life].
Ileal-pouch anal anastomosis (IPAA) following coloproctectomy avoids permanent ileostomy, and allows complete excision of diseased mucosa in ulcerative colitis (UC) and adenomatous polyposis. Preserving normal intestinal pattern, the goal of IPAA is to improve quality of life for patients. This study was designed to measure the impact of IPAA on quality of life in a series of 35 surgically treated UC. Four fields of quality of life were explored: diet, professional activity, sport practice, sexual activity. Interview with independent observer and prospective follow-up allowed to establish a score from 0 (excellent quality of life) to 19 (bad quality of life). In the same time, functional score evaluating pouch evacuation and continence was established (0 = excellent function, 30 = bad function) to be compared to quality of life. The series included 35 IPAA in function for more than 6 months (mean follow-up = 46 +/- 31 months), performed for UC (14 females and 21 males, mean age: 34 y-a). Respectively 30 (86%) and 5 (14%) of the patients had an excellent and fair quality of life, according to the scoring system: 25 had no diet, all but one had a normal professional activity and all were satisfied of sport practice; 33 had no sexual disturbances related to IPAA, but 3 female patients complained of infertility. Functional results were excellent, fair and bad respectively in 25 (72%), 9 (26%) and 1 patients: stool frequency was 4.6 +/- 2 per day, 60% of patients having no nocturnal emission, and 90% being able to delay for more than 1 hour.(ABSTRACT TRUNCATED AT 250 WORDS)
Lehur
P A
PA
Clinique chirurgicale II, Hôpital G et R Laennec, Nantes.
Guiberteau-Canfrere
V
V
Galmiche
J P
JP
Le Bodic
L
L
Le Borgne
J
J
D000293:Adolescent; D000328:Adult; D003093:Colitis, Ulcerative / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D016737:Proctocolectomy, Restorative; D011446:Prospective Studies; D011788:Quality of Life
Qualité de vie et anastomose iléo-anale avec réservoir. Résulats d'une série prospective de 35 rectocolites hémorragiques opérée. Proposition d'un score de qualité de vie.