Functional outcome, quality of life, and complications after ileal pouch-anal anastomosis in selected septuagenarians.
OBJECTIVE
Concerns about morbidity and functional outcome have lead some authors to suggest that ileal pouch-anal anastomosis should not be performed in older patients. This article evaluates the outcome of selected septuagenarians undergoing ileal pouch-anal anastomosis at this institution.


METHODS
Seventeen of 1,911 patients undergoing ileal pouch-anal anastomosis for ulcerative colitis were older than the age of 70 at the time of surgery. Functional outcome, quality of life, and manometric data were assessed prospectively, whereas complications were assessed by chart review.


RESULTS
There was one mortality related to sepsis after small-bowel obstruction and one reoperation at 18 months for pelvic abscess. Minor complications occurred in five patients. Median (interquartile range) quality of life and health and levels of energy and happiness (scored out of 10) were 9 (7-10), 9 (7-10), 8 (5-10), and 9.5 (7-10), respectively. Medical Outcomes Study Short Form 36 quality of life scores were not different from those for the healthy population older than 65 years. There was complete continence in 38 percent, rare incontinence in 12 percent, and some incontinence in 50 percent. Nobody was usually or always incontinent. Overall, 82 percent would undergo pouch surgery again, and 89 percent would recommend it to others.


CONCLUSIONS
Ileal pouch-anal anastomosis is an acceptable surgical option for selected healthy, motivated septuagenarians with ulcerative colitis who are eager to preserve fecal continence.
Department of Colorectal Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Conor P
CP
Delaney
Babak
B
Dadvand
Feza H
FH
Remzi
James M
JM
Church
Victor W
VW
Fazio
D000368:Aged; D001003:Anal Canal / Q000502:physiology; D003093:Colitis, Ulcerative / Q000601:surgery*; D003672:Defecation / Q000502:physiology; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008365:Manometry; D017060:Patient Satisfaction; D011183:Postoperative Complications; D016737:Proctocolectomy, Restorative / Q000009:adverse effects*; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function