Restorative proctocolectomy. Does ethnicity affect outcome?
OBJECTIVE
Restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis (IPAA) is well-established in the management of ulcerative colitis (UC) and familial adenomatous polyposis (FAP). We review outcome of pouch surgery from a single centre, comparing non-South Asian and South Asian Caucasian populations.


METHODS
Patients undergoing RPC for UC and FAP during a 10-year period between January 1997 and January 2007 were identified from hospital records. Data were collected retrospectively from case notes on early and long-term results.


RESULTS
A total of 107 patients underwent pouch formation for UC (94%) or FAP (6%) and 22 (21%) were from the Asian subcontinent. Eighty-seven (81%) underwent a three-stage procedure and 20 (19%) a two-stage procedure. Postoperative complications occurred in 40 (37%) patients, being major in 11 (10%) patients with relaparotomy required in 9 (8%) with no difference between South Asian and non-South Asian Caucasian patients. Long-term pouch function, with a median of five times over 24 h (range 2-15), was similar between the two groups. The incidence of pouchitis was 57 (53%) and this was significantly greater in the South Asian population [17/21 (77%); 39/86 (46%); P = 0.006].


CONCLUSIONS
Surgical results were similar in South Asian and non-South Asian Caucasian patients, but the incidence of pouchitis was greater in the former group.
Norwood
M G A
MG
Department of Surgery, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester LE1 5WW, UK.
Mann
C D
CD
West
K
K
Miller
A S
AS
Hemingway
D
D
D011125:Adenomatous Polyposis Coli / Q000208:ethnology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D044466:Asian People; D039021:Colonic Pouches / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019449:Pouchitis / Q000208:ethnology* / Q000209:etiology*; D016737:Proctocolectomy, Restorative / Q000009:adverse effects*; D012189:Retrospective Studies; D044465:White People; D055815:Young Adult