Age-related analysis of functional outcome and quality of life after restorative proctocolectomy and ileal pouch-anal anastomosis for familial adenomatous polyposis.
BACKGROUND
The aim of the present study was to evaluate the influence of a younger age at the time of ileal pouch-anal anastomosis (IPAA) on functional outcome and quality of life in patients with familial adenomatous polyposis (FAP).


METHODS
A total of 105 patients with FAP who had undergone IPAA were retrieved from a dedicated Institutional Review Board (IRB)-approved IPAA database. Fifty-three patients who had complete follow-up data at 1, 3 and 5 years were included in the study. Patients were categorized into three groups according to their ages at the time of surgery. Group 1, patients < or =20 years of age (n = 9); group 2, patients >20 and < or = 40 years of age (n = 23); and group 3, patients >40 years of age (n = 21). Perioperative characteristics, postoperative complications, quality of life scores and functional outcome at 1, 3 and 5 years of postoperative follow-up were assessed.


RESULTS
At any time point, there were no significant differences among the groups in terms of perioperative characteristics, quality of life scores or level of satisfaction with the procedure. However, younger patients had significantly lower nocturnal bowel movements at the first and third years of follow-up and tended to have less bowel movements per day at all stages of follow-up.


CONCLUSIONS
These findings indicate that younger patients with FAP are inclined to have better functional outcome after IPAA in the early postoperative period. This finding may be encouraging for colorectal surgeons who will operate on young patients with FAP.
Erkek
Ayhan B
AB
Department of Colorectal Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA. bulenterkek@gmail.com
Church
James M
JM
Remzi
Feza H
FH
D011125:Adenomatous Polyposis Coli / Q000503:physiopathology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000714:Anastomosis, Surgical / Q000009:adverse effects; D039021:Colonic Pouches / Q000009:adverse effects*; D019992:Databases as Topic; D003672:Defecation; D005242:Fecal Incontinence / Q000209:etiology* / Q000503:physiopathology; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D016737:Proctocolectomy, Restorative / Q000009:adverse effects*; D011788:Quality of Life; D020127:Recovery of Function; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome