title: Assessment of age in ulcerative colitis patients with ileal pouch creation - an evaluation of outcomes.
abstract: BACKGROUND
  The aim of the study was to determine if age at the creation of an ileal pouchanal anastomosis (IPAA) has an impact on the outcomes in patients with ulcerative colitis (UC).
  
  
  METHODS
  A retrospective review of all patients who underwent IPAA for UC from 1999 to 2011 was performed. Long-term functional outcome was assessed using both the Cleveland Clinic and St Mark's incontinence scores.
  
  
  RESULTS
  Eighty-nine patients, with a median age of 46 (range, 16 to 71) years, formed the study group. The median duration of disease prior to their pouch surgery was 7 (0.5 to 39) years. There were 57 (64%) patients who were aged ≤50 years old and 32 (36%) who were >50 years old. Fifty-seven (64%) patients developed perioperative complications of which 51 (89.5%) were minor. High ileostomy output (n = 21, 23.6%) and urinary symptoms (n = 13, 14.6%) were the most commonly encountered complications. The older patients were more likely to have an ASA score ≥3 and a longer length of stay. Although there was a higher incidence of complications in the older group of patients, the difference was not statistically significant. There were no significant differences in the incidence of severe complications. Forty-nine (55%) patients completed our questionnaire on the evaluation of their functional outcomes. There were no significant differences in the Cleveland Clinic and St Mark's incontinence scores between the older (n = 19, 38.8%) and younger (n = 30, 61.2%) patients. There were also no significant differences in the frequency of bowel movements during the day or overnight after sleep between the 2 groups.
  
  
  CONCLUSIONS
  IPAA procedure for patients with UC can be safely performed. Long-term functional outcome is not significantly influenced by the age at which the IPAA was created.
authors.affiliation: Division of Colorectal Surgery, University Surgical Cluster, National University Hospital, Singapore.
authors.forename: Ker Kan
authors.initials: KK
authors.lastname: Tan
authors.forename: Ragavan
authors.initials: R
authors.lastname: Manoharan
authors.forename: Saissan
authors.initials: S
authors.lastname: Rajendran
authors.forename: Praveen
authors.initials: P
authors.lastname: Ravindran
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Young
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D003093:Colitis, Ulcerative / Q000601:surgery*; D039021:Colonic Pouches; D005242:Fecal Incontinence / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology; D016737:Proctocolectomy, Restorative; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult