Effect of small bowel obstruction on functional outcome and quality of life in patients with ileal pouch-anal anastomosis: 10-year follow-up study.
OBJECTIVE
Postoperative abdominal adhesion formation is a troublesome clinical problem and a common cause of intestinal obstruction, chronic pain and infertility. The aim of this study was to evaluate the effect of small bowel obstruction (SBO) on functional outcome and quality of life (QOL) in patients who experienced ileal pouch-anal anastomosis (IPAA).


METHODS
A total of 2418 patients who had undergone IPAA were categorized into three groups: group 1 comprised patients who had no SBO episodes until the last follow-up; group 2 comprised patients who had one or more SBO episodes treated medically; and group 3 comprised patients who had one or more SBO episodes, at least one of which was treated surgically. Functional outcomes and QOL scores for patients in each group were evaluated at 1, 3, 5 and 10 years of follow-up using multivariate analysis.


RESULTS
We found that patients who had SBO episodes which were treated medically were more likely to have a higher number of total bowel movements in a day in the first year of follow-up compared to patients without postoperative SBO (P = 0.03), and more seepage during the day at 10 years follow-up compared to patients with no SBO episodes or surgically treated SBO episodes (P = 0.01). The Cleveland Global Quality of Life (CGQL) scores were comparable between the three groups at 1, 3, 5 and 10 years of follow-up.


CONCLUSIONS
Medical management of SBO is associated with an increase in two symptoms, but QOL is comparable with surgical management.
Erkek
Ayhan B
AB
Department of Colorectal Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Remzi
Feza H
FH
Hammel
Jeffrey P
JP
Akyuz
Muhammet
M
Fazio
Victor W
VW
D001003:Anal Canal / Q000601:surgery; D000714:Anastomosis, Surgical / Q000009:adverse effects; D039021:Colonic Pouches / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000601:surgery; D007415:Intestinal Obstruction / Q000209:etiology*; D007421:Intestine, Small; D008297:Male; D016737:Proctocolectomy, Restorative / Q000009:adverse effects*; D011788:Quality of Life; D020127:Recovery of Function; D000267:Tissue Adhesions / Q000209:etiology