title: Restorative proctocolectomy with two different pouch designs: few complications with good function.
abstract: OBJECTIVE
  The object of this study was to compare function and quality of life after restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis (IPAA) surgery having two different pouch designs.
  
  
  METHODS
  Patients having RPC in an academic unit from 2000 who had had the loop-ileostomy closed by June 2013 were identified from the hospital medical records. They were sent a questionnaire regarding quality of life and interviewed using a pouch function score (PFS) described by Oresland (score 0-16, higher scores denote worse function).
  
  
  RESULTS
  One hundred and three patients underwent surgery, of whom 56 had a J-pouch design and 47 a K-pouch design, this being a double-folded Kock pouch without the nipple valve. No patients have had the pouch removed or defunctioned due to failure at a mean of 8 years. The reoperation rate was 11.6%. The mean PFS was 5.43 and 5.27 for J- and K-pouches, respectively (P = 0.766). More patients with a J-pouch reported a social handicap due to poor bowel function (P = 0.041). Patients with a PFS ≥ 8 had a poorer quality of life. A score of ≥ 8 was reported by 16% of K-pouch and 25% of J-pouch patients (P = 0.29).
  
  
  CONCLUSIONS
  RPC is a safe procedure with a low complication rate and good functional outcome. Small improvements in function have an impact on a patient's quality of life. Although the J-pouch is the most commonly used, the K-pouch has some advantages. Other pouch designs deserve further evaluation.
authors: Department of Colorectal Surgery, Akershus University Hospital, Lørenskog, Norway.|Clinic of Surgical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway.
authors: M L
authors: ML
authors: Sunde
authors: Department of Colorectal Surgery, Akershus University Hospital, Lørenskog, Norway.|Clinic of Surgical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway.
authors: T
authors: T
authors: Øresland
authors: Department of Colorectal Surgery, Akershus University Hospital, Lørenskog, Norway.
authors: A E
authors: AE
authors: Faerden
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D039021:Colonic Pouches / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007081:Ileostomy / Q000379:methods*; D007410:Intestinal Diseases / Q000503:physiopathology / Q000601:surgery*; D007422:Intestines / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D016737:Proctocolectomy, Restorative / Q000295:instrumentation* / Q000379:methods; D011474:Prosthesis Design / Q000706:statistics & numerical data*; D011788:Quality of Life; D020127:Recovery of Function; D012086:Reoperation / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
keywords: Ileal pouch-anal anastomosis; pouch design; pouch function; quality of life; restorative proctocolectomy; ulcerative colitis