Long-term outcome after ileal pouch-anal anastomosis for ulcerative colitis

Abstract An ileal pouch is usually reconstructed as an alternative to a neorectum after a total proctocolectomy for ulcerative colitis (UC). However, the real defecatory function of an ileal pouch is uncertain. This study was designed to analyze the functional and clinical outcomes after a proctocolectomy and ileal pouch–anal anastomosis (IPAA) for UC using fecoflowmetry (FFM). Sixteen patients who underwent IPAA for UC between 1990 and 2005 were studied. They were evaluated by FFM, together with Kelly's clinical score (KCS), and anorectal manometric assessments were also performed. FFM showed that the fecoflow pattern (FFP) of 14 patients (87%) was the block type and of 2 patients (13%) was the segmental type. The clinical score and tolerance volume showed no improvement 1 year or more after IPAA. However, the value of the maximum fecal stream flow rate (Fmax) improved with time. FFM shows that the defecatory function improved after IPAA, and it may therefore contribute to a good long-term outcome after the surgery.

Download Full-text

Long-term outcomes following restorative proctocolectomy ileal pouch-anal anastomosis in pediatric ulcerative colitis patients: Multicenter national study in Japan

Annals of Gastroenterological Surgery ◽

10.1002/ags3.12198 ◽

2018 ◽

Vol 2 (6) ◽

pp. 428-433 ◽

Cited By ~ 1

Author(s):

Hiroki Ikeuchi ◽

Motoi Uchino ◽

Akira Sugita ◽

Kitaro Futami ◽

Kouhei Fukushima ◽

...

Keyword(s):

Ulcerative Colitis ◽

Restorative Proctocolectomy ◽

Ileal Pouch ◽

Ileal Pouch Anal Anastomosis ◽

National Study ◽

Long Term Outcomes ◽

Anal Anastomosis

Download Full-text

Transanal Ileal Pouch-Anal Anastomosis for Ulcerative Colitis has Comparable Long-Term Functional Outcomes to Transabdominal Approach: A Multicentre Comparative Study

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz174 ◽

2019 ◽

Vol 14 (6) ◽

pp. 726-733 ◽

Cited By ~ 3

Author(s):

Pramodh Chandrasinghe ◽

Michele Carvello ◽

Karin Wasmann ◽

Caterina Foppa ◽

Pieter Tanis ◽

...

Keyword(s):

Quality Of Life ◽

Ulcerative Colitis ◽

Functional Outcomes ◽

Ileal Pouch ◽

Cohort Analysis ◽

Ileal Pouch Anal Anastomosis ◽

Global Quality Of Life ◽

Anal Anastomosis

Abstract Background The transanal approach to ileal pouch-anal anastomosis [Ta-IPAA] provides better access to the lower pelvis with lower short-term morbidity in ulcerative colitis [UC]. The aim of this study was to assess the long-term functional outcomes after Ta-IPAA vs transabdominal IPAA [Abd-IPAA] in UC. Methods A multicentre cohort analysis was performed between March 2002 and September 2017. Patient characteristics, surgical details and postoperative outcomes were compared. CGQL [Cleveland global quality of life] score at 12 months with a functioning pouch was considered the primary end point. Results A total of 374 patients [100 Ta-IPAA vs 274 Abd-IPAA] were included. Ta-IPAA demonstrated a comparable overall quality of life [CGQL score] to Abd-IPAA [0.75 ± 0.11 vs 0.71 ± 0.14; respectively, p = 0.1]. Quality of life [7.71 ± 1.17 vs 7.30 ± 1.46; p = 0.04] and energy-level items [7.16 ± 1.52 vs 6.66 ± 1.68; p = 0.03] were significantly better after Ta-IPAA, while the quality of health item was comparable [7.68 ± 1.26 vs 7.64 ± 1.44; p = 0.96]. Analysis excluding anastomotic leaks did not change the overall CGQL scores. Stool frequencies [>10/24 h: 22% vs 21%; p = 1.0] and the rate of a single episode of major incontinence during the following 12-month period [27% vs 26%; p = 0.89] were similar. The differences in 30-day morbidity rates [33% vs 41%; p = 0.2] and anastomotic leak rates were not significant [6% vs 13%; p = 0.09]. Conclusions This study provides evidence of comparable long-term functional outcome and quality of life after Ta-IPAA and Abd-IPAA for UC.

Download Full-text