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Long‐term functional outcome after restorative proctocolectomy in patients with ulcerative colitis
Author(s) -
Karlbom U.,
Lindfors A.,
Påhlman L.
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.1463-1318.2011.02873.x
Subject(s) - pouchitis , medicine , ulcerative colitis , proctocolectomy , pouch , anastomosis , gastroenterology , surgery , disease
Aim The aim of this study was to evaluate the long‐term functional outcome of ileal pouch–anal anastomosis for ulcerative colitis and to compare symptoms over time. Methods In all, 188 patients were operated with an ileal pouch–anal anastomosis. Short‐term functional outcome has previously been evaluated with a symptom questionnaire. The same questionnaire was sent to the 162 patients who were alive and had an intact pouch. A symptom index was studied over time and in relation to early complications and pouchitis. Results The response rate of the questionnaire was 139/162 at a median of 12.5 (9.5–21) years postoperatively. Overall, the symptom index remained unchanged over time but both the frequency of night‐time defaecation and episodes of night‐time incontinence increased. Patients’ global assessment was unchanged with approximately 80% stating an excellent or a good result. Frequency of pouchitis doubled in 10 years. Symptom index for patients with episodic pouchitis [median 40 (8–89), P = 0.018] and recurrent/chronic pouchitis [71 (8–136), P < 0.001] was higher than in patients without pouchitis [29 (0–105)]. Early complications did not affect the symptom index. Conclusion The overall functional outcome of ileal pouch–anal surgery for ulcerative colitis is stable over time. Patients’ satisfaction with outcome remains high. Pouchitis is a determinant of functional outcome.