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Gender of the patient may influence perioperative and long‐term complications after restorative proctocolectomy
Author(s) -
Rottoli M.,
Remzi F. H.,
Shen B.,
Kiran R. P.
Publication year - 2012
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/j.1463-1318.2011.02634.x
Subject(s) - medicine , pouch , perioperative , anastomosis , proctocolectomy , multivariate analysis , male gender , incidence (geometry) , ileostomy , surgery , ulcerative colitis , disease , physics , optics
Aim Gender‐related differences in preoperative characteristics and early and long‐term outcome for patients undergoing ileal pouch anal anastomosis (IPAA) have not previously been well studied. Method All male and female patients undergoing IPAA at a single centre between 1983 and 2008 were compared for perioperative variables and long‐term outcome. Statistical tests were used as appropriate. A multivariate analysis was performed to evaluate the effects of gender on pouch failure. Results Female patients ( n = 1495) were younger than male patients ( n = 1912) ( P < 0.001). Surgery type and pouch configuration were similar, although male gender was associated with a higher use of ileostomy ( P < 0.001) and a higher incidence of 30‐day anastomotic separation ( P = 0.001). During a median follow up of 9.9 (female) and 9.3 (male) years, female patients were more likely to develop bowel obstruction (20.8 vs 16.7%, P = 0.02) and pouch‐related fistula (10.9 vs 7.6%, P = 0.001). Women had a higher number of daily bowel movements than men ( P = 0.001), and more frequently had urgency ( P = 0.001), daily seepage ( P = 0.01) and pad use ( P < 0.001). A higher percentage of female patients reported dietary ( P < 0.001) and work ( P = 0.022) restrictions and lower mental component of the Short‐Form 36 quality of life score ( P = 0.018). On multivariate analysis of perioperative variables, female gender was associated with pouch failure ( P = 0.05). Conclusion The gender of the patient seems to be associated with specific differences in preoperative variables and postoperative outcomes for patients undergoing IPAA.