[Long term functional outcomes after ileoanal pouch in patients with and without postoperative complications].
BACKGROUND
the proctocolectomy with ilealpouch (IP) has become the gold standard for surgical treatment for ulcerative colitis (UC). The postoperative complications are frequent but the definitive outcome is acceptable.


OBJECTIVE
our aim was to evaluate the long term functional outcome in a series of consecutive patients with IP and to establish its relation with postoperative complications.


METHODS
we included 144 patients categorized in two groups: I--patients without postoperative complications (n: 71); II--patients with postoperative complications (n: 73). Patients were followed for a median time of 3.8 years (range 1-15). We evaluated: stool frequency, anal discrimination between gas and stool, voluntary evacuation inhibition, requirement of antidiarrheal medications and presence of incontinence.


RESULTS
the functional outcome was similar between the two groups in terms of stool fequency medication use, anal discrimination and the voluntary inhibition of evacuation for more than 5 hours. A trend to present seepage was seen in patients with complications (34%) more than in those without them (20%; p<0.08 NS). Compared with group II, seepage in group I was significantly related with dietary lapses (p<0.01). The most frequent complication in incontinent patients was pelvic sepsis (56%).


CONCLUSIONS
our study showed that most of long-term functional parameters are not influenced by the presence of postoperative complications. However, a trend for incontinence seems to be related to postoperative complications, more frequently with pelvic sepsis.
Gualdrini
Ubaldo
U
Unidad de Proctologia, Hospital de Gastroenterología, Dr Carlos Bonorino Udaondo, Ciudad Autónoma de Buenos Aires, Argentina. uagualdrini@fibertel.com.ar
Coraglio
Mariana
M
Filippa
Laura
L
Masciangioli
Guillermo
G
Gutiérrez
Alejandro
A
Lumi
Carlos
C
Graziano
Alfredo
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003093:Colitis, Ulcerative / Q000601:surgery*; D039021:Colonic Pouches / Q000009:adverse effects; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016737:Proctocolectomy, Restorative / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome