Long-term clinical outcome and anemia after restorative proctocolectomy for ulcerative colitis.
BACKGROUND
The purpose of this study was to evaluate long-term outcome and hematologic data after restorative proctocolectomy (RPC) and mucosectomy with hand-sewn J-pouch-anal anastomosis for ulcerative colitis (UC).


METHODS
Forty-eight (75%) out of 64 consecutive patients operated on during the period 1985-1990 participated in a long-term follow-up in 1998. Study visits involved an interview according to a 23-item functional questionnaire, pouch endoscopy and blood samples. Pre- and postoperative data on these patients were reviewed at our own database covering all operations performed for UC at our institute.


RESULTS
Functional disturbances were common and unchanged during long-term follow-up. Minor incontinence occurred in 37.5% and outlet difficulties in 10.5% of patients. Bowel obstruction occurred in 16.7% and usually needed operative treatment. Twenty-four (50.0%) patients had had at least one episode of pouchitis and chronic or severe pouchitis occurred in 18 (37.5%) cases. Males seem to have chronic pouchitis more often. Ten (20.8%) patients had anemia during follow-up. Recurrent bleeding from the pelvic pouch and chronic pouchitis exposed to the anemia.


CONCLUSIONS
Minor morbidity is common after RPC. Pouchitis occurred in half of our patients during long-term follow-up. There may be a risk of anemia with chronic pouchitis and bleeding from the pelvic pouch mucosa.
Tiainen
J
J
Dept. of Surgery, Tampere University Hospital, Finland.
Matikainen
M
M
D000328:Adult; D000368:Aged; D000740:Anemia / Q000097:blood / Q000209:etiology*; D003093:Colitis, Ulcerative / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016737:Proctocolectomy, Restorative / Q000009:adverse effects*