title: Long-term functional outcome after ileal pouch anal anastomosis in 191 patients with ulcerative colitis.
abstract: BACKGROUND
  A long-lasting good functional outcome of the pelvic pouch and a subsequent satisfying quality of life (QoL) are mandatory. Long-term functional outcome and QoL in a single-center cohort were assessed.
  
  
  METHODS
  A questionnaire was sent to all patients with an IPAA for UC, operated between 1990 and 2010 in our department. Pouch function was assessed using the Öresland Score (OS) and the 'Pouch Functional Score' (PFS). QoL was assessed using a Visual Analogue Score (VAS).
  
  
  RESULTS
  250 patients (42% females) with a median age at surgery of 38 years (interquartile range (IQR): 29-48 years) underwent restorative proctocolectomy. Median follow-up was 11 years (IQR: 6-17 years). Response rate was 81% (n=191). Overall pouch function was satisfactory with a median OS of 6/15 (IQR: 4-8) and a median PFS of 6/30 (IQR: 3-11). 24-hour bowel movement is limited to 8 times in 68% of patients (n=129), while 55 patients (29%) had less than 6 bowel movements. 12 patients (6.5%) were regularly incontinent for stools, while 154 patients (82%) reported a good fecal continence. Fecal incontinence during nighttime was more common (n=72, 39%). Pouch function had little impact on social activity (4/10; IQR: 2-6) and on professional activity (3/10; IQR: 1-6). 172 patients (90%) reported to experience an overall better health condition since their operation. The OS and the PFS correlated well (Pearson's correlation coefficient=0.83). Overall pouch function was stable over time.
  
  
  CONCLUSIONS
  Majority of patients report a good pouch function on the long-term with limited impact on QoL.
authors.affiliation: Department of Abdominal Surgery, University Hospital Gasthuisberg Leuven, Belgium. Electronic address: anthony.debuckvanoverstraeten@uzleuven.be.
authors.forename: A
authors.initials: A
authors.lastname: de Buck van Overstraeten
authors.affiliation: Department of Abdominal Surgery, University Hospital Gasthuisberg Leuven, Belgium.
authors.forename: A M
authors.initials: AM
authors.lastname: Wolthuis
authors.affiliation: Department of Gastroenterology, University Hospital Gasthuisberg Leuven, Belgium.
authors.forename: S
authors.initials: S
authors.lastname: Vermeire
authors.affiliation: Department of Gastroenterology, University Hospital Gasthuisberg Leuven, Belgium.
authors.forename: G
authors.initials: G
authors.lastname: Van Assche
authors.affiliation: Interuniversity Center for Biostatistics and Statistical Bioinformatics, University Hospital Gasthuisberg Leuven, Belgium.
authors.forename: A
authors.initials: A
authors.lastname: Laenen
authors.affiliation: Department of Gastroenterology, University Hospital Gasthuisberg Leuven, Belgium.
authors.forename: M
authors.initials: M
authors.lastname: Ferrante
authors.affiliation: Department of Gastroenterology, University Hospital Gasthuisberg Leuven, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: Rutgeerts
authors.affiliation: Department of Abdominal Surgery, University Hospital Gasthuisberg Leuven, Belgium.
authors.forename: A
authors.initials: A
authors.lastname: D'Hoore
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000601:surgery*; D000714:Anastomosis, Surgical; D003093:Colitis, Ulcerative / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D039021:Colonic Pouches / Q000009:adverse effects; D003672:Defecation; D018572:Disease-Free Survival; D004651:Employment; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D016737:Proctocolectomy, Restorative; D011788:Quality of Life; D058992:Social Participation; D011795:Surveys and Questionnaires; D015996:Survival Rate; D013997:Time Factors
keywords: Functional outcome; IPAA; Long-term function; Pelvic pouch