title: Factors influencing the functional outcome of restorative proctocolectomy in ulcerative colitis.
abstract: BACKGROUND
  Restorative proctocolectomy is considered to be the procedure of choice in the operative treatment of ulcerative colitis. The aim of this study was to evaluate the functional outcome following operation and to identify possible predictive factors.
  
  
  METHODS
  Some 168 patients (median age 32 years, 102 men) with ulcerative colitis underwent restorative proctocolectomy. The functional outcome was evaluated by a symptom index created from a questionnaire at a median of 29 (13-123) months of follow-up. The records of these patients were reviewed, and preoperative, peroperative and postoperative variables were registered and related to outcome.
  
  
  RESULTS
  The response rate to the questionnaire was 155 (92 per cent) of 168. The symptom index was related to patients' overall assessment of outcome. In spite of a perceived good result many patients experienced a number of symptoms. Age over 50 years (P < 0.01), presence of extraintestinal manifestations (P < 0.05) and late complications, such as anastomotic stricture (P < 0.05), pouchitis (P < 0.01) and anal pain (P < 0.05), were related to a less favourable outcome.
  
  
  CONCLUSIONS
  While preoperative data may help in selecting patients suitable for restorative proctocolectomy, prevention of late complications seems most important in improving the functional outcome.
authors.affiliation: Department of Surgery, University Hospital, S-751 85 Uppsala, Sweden.
authors.forename: U
authors.initials: U
authors.lastname: Karlbom
authors.forename: Y
authors.initials: Y
authors.lastname: Raab
authors.forename: S
authors.initials: S
authors.lastname: Ejerblad
authors.forename: W
authors.initials: W
authors.lastname: Graf
authors.forename: M
authors.initials: M
authors.lastname: Thörn
authors.forename: L
authors.initials: L
authors.lastname: Pâhlman
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D003093:Colitis, Ulcerative / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011300:Preoperative Care; D016737:Proctocolectomy, Restorative / Q000379:methods*; D012044:Regression Analysis; D016896:Treatment Outcome