Results at Up to 30 Years After Ileal Pouch–Anal Anastomosis for Chronic Ulcerative Colitis. Issue 5 (May 2017)

• Record Type: Journal Article
• Authors: Lightner, Amy L.; Mathis, Kellie L.; Dozois, Eric J.; Hahnsloser, Dieter; Loftus, Edward V.; Raffals, Laura E.; Pemberton, John H.
• Is Part Of: Inflammatory bowel diseases. Volume 23:Issue 5(2017)
• Publication Date: 2017-05
• Subjects: IPAA -- pouch function -- pouch QoL; Inflammatory bowel diseases -- Periodicals; Colitis, Ulcerative -- Periodicals; Crohn Disease -- Periodicals; Inflammatory Bowel Diseases -- Periodicals; 616.344
• DOI: 10.1097/MIB.0000000000001061
• Languages: English
• ISSNs: 1078-0998

Abstract

Abstract : Background: Ileal pouch–anal anastomosis (IPAA) has become the surgical procedure of choice for patients with chronic ulcerative colitis. No study to date has examined functional and quality-of-life outcomes 30 years after pouch construction. Methods: Using data from a prospectively maintained database with annually distributed questionnaires, functional outcomes, pouch complications, and quality of life after IPAA were determined. Results: Overall, 93.3% of patients had a functioning pouch at 30 years. Stool frequency during the day increased slightly from a mean of 5.7 (SD, 2.3) at 1 year to 6.2 (SD, 2.9) at 30 years ( P < 0.001); nighttime frequency also increased slightly from 1.5 (SD, 1.2) to 2.1 (SD, 1.2) ( P < 0.001). Pouch outcomes and stool frequency were significantly associated with diagnosis, being worse in patients with Crohn's disease, but were minimally associated with age greater than 65 years. After IPAA, the 30-year cumulative probability of pouchitis, stricture, obstruction, and fistula were 80.2%, 56.7%, 44.0%, and 15.8%, respectively. Quality of life scores remained stable over the 30 years. Conclusions: IPAA is a durable operation for patients requiring proctocolectomy for chronic ulcerative colitis and indeterminate colitis. The functional outcomes and quality of life remained relatively unchanged over the 30 years after IPAA underscoring the longevity of pouches. Abstract : Article first Published online 15 March 2017Supplemental Digital Content is Available in the Text.