title: Clinical outcomes of ileorectal anastomosis for ulcerative colitis.
abstract: BACKGROUND
  The aim of this study was to determine the fate of the rectum, functional results and quality of life after ileorectal anastomosis (IRA) in ulcerative colitis.
  
  
  METHODS
  Patients with ulcerative colitis and indeterminate colitis who underwent IRA from 1971 to 2006 were evaluated retrospectively. Twenty-two patients with an IRA were matched by age, sex and follow-up duration with 66 patients with an ileal pouch-anal anastomosis (IPAA) and compared for functional outcomes and quality of life.
  
  
  RESULTS
  Eighty-six patients with an IRA were included. Median follow-up was 9 (range 1-36) years. Rectal dysplasia and cancer rates were 17 and 8 per cent respectively. The rectum was resected in 46 patients (53 per cent) because of refractory proctitis in 24, rectal dysplasia in 15 and rectal cancer in seven. The cumulative probability of having a functioning IRA at 10 and 20 years was 74 and 46 per cent respectively. Patients with an IRA had fewer bowel movements (P = 0.020) and less night-time seepage (P = 0.020) but increased urgency (P < 0.001) compared with patients with an IPAA, whereas quality of life was similar.
  
  
  CONCLUSIONS
  In selected patients with ulcerative colitis IRA gives an acceptable quality of life and functional outcome that are comparable to those in patients with an IPAA. Owing to the risk of cancer, surveillance of the rectum is mandatory.
authors.affiliation: Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Ohio, USA.
authors.forename: A
authors.initials: A
authors.lastname: da Luz Moreira
authors.forename: R P
authors.initials: RP
authors.lastname: Kiran
authors.forename: I
authors.initials: I
authors.lastname: Lavery
mesh_terms: D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical; D003093:Colitis, Ulcerative / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007082:Ileum / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012004:Rectal Neoplasms / Q000209:etiology / Q000503:physiopathology; D012007:Rectum / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult