title: Outcome after ileal pouch-anal anastomosis for familial adenomatous polyposis compared to mucosal ulcerative colitis in a Middle Eastern population.
abstract: OBJECTIVE
  To compare the complications and outcome after ileal pouch-anal anastomosis (IPAA) for mucosal ulcerative colitis (MUC) and familial adenomatous polyposis (FAP).
  
  
  METHODS
  This is a retrospective study. The study was conducted at a single tertiary referral center.
  
  
  METHODS
  All patients who underwent restorative proctocolectomy with IPAA at a tertiary center in Saudi Arabia from 2001 till 2009 were retrieved. Data was obtained regarding preoperative status, postoperative complications, and functional outcome.
  
  
  RESULTS
  A total of 40 patients underwent IPAA, of which 21 cases were of FAP and 19 cases of MUC. Median age at operation for FAP and MUC was 31 (range: 16-45) and 43 (range: 15-65) years, respectively (P < .05). Median length of stay was 10 days (range: 6-42) for FAP and 12 days (range: 9-27) for MUC (P=.1). Postoperative morbidity was noted in 4 cases of FAP and 6 cases of MUC (P=.36). Specifically, wound infection was noted in 2 cases of FAP compared to 3 cases of MUC (P=.55); 1 MUC case had an anastomotic leak (P=.29). One mortality was recorded among the FAP cases (P=.35). The time between the creation of IPAA and the closure of ileostomy was 4.5 and 5 months for FAP and MUC, respectively (P=.87). Median follow-up was 36 months. Median bowel frequency per 24 hours was 6 (range: 3-24) for FAP and 7 (range 3-17) for MUC (P=.54). Intestinal obstruction was reported in 3 cases of FAP and 5 cases of MUC (P=.38). One pouch was excised in a FAP patient. One case of MUC developed pouchitis.
  
  
  CONCLUSIONS
  The outcome after IPAA was inferior for MUC compared to FAP, but it was not statistically significant due to the small sample size. The morbid status of the MUC cases and their older age contributed to the minor differences.
authors.affiliation: Department of Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. nsanea@kfshrc.edu.sa
authors.forename: Nasser
authors.initials: N
authors.lastname: Al-Sanea
authors.forename: Jaber
authors.initials: J
authors.lastname: Alfaifi
authors.forename: Samar Al
authors.initials: SA
authors.lastname: Homoud
authors.forename: Alaa
authors.initials: A
authors.lastname: Abduljabbar
authors.forename: Denise
authors.initials: D
authors.lastname: Hibbert
authors.forename: Luai
authors.initials: L
authors.lastname: Ashari
mesh_terms: D011125:Adenomatous Polyposis Coli / Q000503:physiopathology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001003:Anal Canal / Q000601:surgery; D000714:Anastomosis, Surgical / Q000379:methods*; D003093:Colitis, Ulcerative / Q000503:physiopathology / Q000601:surgery*; D039021:Colonic Pouches; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D016737:Proctocolectomy, Restorative / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D012529:Saudi Arabia; D016896:Treatment Outcome; D055815:Young Adult