Quality of life in patients undergoing ileal pouch-anal anastomosis at the University of Cincinnati.
BACKGROUND
In 1978, Drs. Fischer and Martin were among the first to preserve anorectal continence and create a pelvic reservoir in adult patients, in what has become the ileal pouch-anal anastomosis (IPAA).


METHODS
Here we review our institutions' experience with 379 of these procedures from 1978 to present. To assess the specific health concerns of patients with ulcerative colitis (UC) and familial adenomatous polyposis (FAP) and determine the effects of IPAA on health-related quality of life, we evaluated patients with the SF-36, the Rating Form of Inflammatory Bowel Disease Patient Concerns (RFIPC), time trade-off questions, and a gamble question.


RESULTS
IPAA patients did not differ from the general population in seven of eight general health categories assessed by the SF-36. When compared with the UC population as a whole using the RFIPC they had reduced concerns in almost all areas. In addition, time trade-off and gamble questions indicated that these patients, as a group, are willing to accept a significant risk of dying in order to achieve their results of the IPAA.


CONCLUSIONS
This high level of satisfaction has led to the referral of patients who would not have otherwise considered a procedure requiring permanent ileostomy.
Robb
Bruce
B
Department of Surgery, University of Cincinnati Medical Center, Cincinnati, Cincinnati, Ohio 45267, USA.
Pritts
Timothy
T
Gang
Gyu
G
Warner
Brad
B
Seeskin
Connie
C
Stoops
Marilyn
M
James
Laura
L
Rafferty
Janice
J
Azizkhan
Richard
R
Martin
Lester
L
Nussbaum
Michael
M
D011125:Adenomatous Polyposis Coli / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000601:surgery*; D000714:Anastomosis, Surgical; D003093:Colitis, Ulcerative / Q000601:surgery; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D016737:Proctocolectomy, Restorative / Q000523:psychology* / Q000639:trends; D011788:Quality of Life; D011795:Surveys and Questionnaires