title: Quality of life after ileal pouch-anal anastomosis and ileorectal anastomosis in patients with familial adenomatous polyposis.
abstract: OBJECTIVE
  Differences in conventional outcomes such as functional results and the rate of complications have caused a controversy about whether the ileal pouch anal anastomosis or the ileorectal anastomosis is the preferred surgical treatment for patients with familial adenomatous polyposis. We therefore sought to ascertain not only the surgical results but also the perceptions of patients about their outcomes.
  
  
  METHODS
  Between 1981 and 1998, 152 patients at our institution had an ileal pouch-anal anastomosis and 32 patients had an ileorectal anastomosis for familial adenomatous polyposis. Of these 184 patients, 173 were sent a study-specific quality-of-life questionnaire and the Short Form 36 health survey to determine their health-related quality of life.
  
  
  RESULTS
  Ninety-four ileal pouch patients and 21 ileorectal patients returned the surveys. No difference was found in early postoperative complications, 5-year probability for complications, or functional results after either procedure. On the Short Form 36 health survey, the ileorectal patients had a lower mental health summary score compared with that of the ileal pouch patients but a similar physical health summary score. The study-specific questionnaire found both groups to have a comparable quality of life.
  
  
  CONCLUSIONS
  Because ileal pouch-anal anastomosis has the advantage of removing as much at-risk tissue as possible with similar functional results and better mental health, it may be considered the preferred operation for most patients with familial adenomatous polyposis.
authors.affiliation: Division of Colon and Rectal Surgery, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905, USA.
authors.forename: Imran
authors.initials: I
authors.lastname: Hassan
authors.forename: Heidi K
authors.initials: HK
authors.lastname: Chua
authors.forename: Bruce G
authors.initials: BG
authors.lastname: Wolff
authors.forename: Stephanie F
authors.initials: SF
authors.lastname: Donnelly
authors.forename: Roger R
authors.initials: RR
authors.lastname: Dozois
authors.forename: Dirk R
authors.initials: DR
authors.lastname: Larson
authors.forename: Cathy D
authors.initials: CD
authors.lastname: Schleck
authors.forename: Heidi
authors.initials: H
authors.lastname: Nelson
mesh_terms: D011125:Adenomatous Polyposis Coli / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D002648:Child; D039021:Colonic Pouches; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007082:Ileum / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016737:Proctocolectomy, Restorative; D011788:Quality of Life; D012007:Rectum / Q000601:surgery*; D016896:Treatment Outcome