Long-term outcome 10 years or more after restorative proctocolectomy and ileal pouch-anal anastomosis in patients with ulcerative colitis.
OBJECTIVE
The aim of this study was to assess quality of life (QOL) in a long-term follow-up of patients with ulcerative colitis (UC) 10 years and more after ileal pouch-anal anastomosis (IPAA) to correlate these results with pouch function and to assess the long-term pouch failure rate.


METHODS
In a unicentric study, 294 consecutive patients after IPAA between 1988 and 1996 were identified from a prospective database. QOL was evaluated according to the validated Gastrointestinal Quality of Life Index (GIQLI).


RESULTS
Overall median follow-up was 11.5 years. Thirty-seven patients experienced pouch failure (12.6%). The rates of ileal pouch success after 5, 10 and 15 years were 92.3%, 88.7% and 84.5%. According to the GIQLI, patients with a functioning pouch achieved a mean score of 107.8, reflecting a decrease of QOL of 10.8% compared to a healthy population. There were significant negative correlations between QOL and an age of >50 years (p < 0.05), pouchitis, perianal inflammation and increased stool frequency (p < 0.0001).


CONCLUSIONS
QOL and functional results of patients with UC 10 years or more after IPAA were acceptable; however, those were reduced when compared to a healthy population. Pouch failure rate still increases up to 15.5% 15 years after IPAA. This result represents an important issue in providing patients with comprehensive preoperative information.
Leowardi
Christine
C
Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany. Christine.Leowardi@med.uni-heidelberg.de
Hinz
Ulf
U
Tariverdian
Mirjam
M
Kienle
Peter
P
Herfarth
Christian
C
Ulrich
Alexis
A
Kadmon
Martina
M
D000328:Adult; D000367:Age Factors; D001003:Anal Canal / Q000601:surgery; D000714:Anastomosis, Surgical / Q000379:methods; D015331:Cohort Studies; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D039021:Colonic Pouches / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D019449:Pouchitis / Q000175:diagnosis / Q000628:therapy; D011336:Probability; D016737:Proctocolectomy, Restorative / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D011788:Quality of Life; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome