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Restorative proctocolectomy with two different pouch designs: few complications with good function
Author(s) -
Sunde M. L.,
Øresland T.,
Færden A. E.
Publication year - 2017
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.13478
Subject(s) - pouch , medicine , proctocolectomy , anastomosis , surgery , quality of life (healthcare) , familial adenomatous polyposis , ulcerative colitis , colorectal cancer , disease , nursing , cancer
Aim 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. Method 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). Conclusion 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.