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Long-term functional outcome after restorative proctocolectomy in patients with ulcerative colitis
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Colorectal Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Colorectal Surgery.
2012 (English)In: Colorectal Disease, ISSN 1462-8910, E-ISSN 1463-1318, Vol. 14, no 8, 977-984 p.Article in journal (Refereed) Published
Abstract [en]

Aim: 

The aim of this study was to evaluate long-term functional outcome of ileal pouch-anal anastomosis for ulcerative colitis and to compare symptoms over time.

Methods:

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 defecation and episodes of night time incontinence increased. Patients' global assessment was unchanged with approximately 80 per cent stating an excellent or a good result. Frequency of pouchitis doubled in ten 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.

Place, publisher, year, edition, pages
2012. Vol. 14, no 8, 977-984 p.
Keyword [en]
Ulcerative colitis, restorative proctocolectomy, ileal pouch–anal anastomosis, functional outcome
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-165332DOI: 10.1111/j.1463-1318.2011.02873.xISI: 000306901200022PubMedID: 22053822OAI: oai:DiVA.org:uu-165332DiVA: diva2:473041
Available from: 2012-01-05 Created: 2012-01-05 Last updated: 2017-12-08Bibliographically approved

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Karlbom, UrbanPåhlman, Lars

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