Evaluation of long-term function, complications, quality of life and health status after restorative proctocolectomy with ileo neo rectal and with ileal pouch anal anastomosis for ulcerative colitis
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Publication year
2013Source
Colorectal Disease, 15, 6, (2013), pp. e323-e329ISSN
Publication type
Article / Letter to editor
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Organization
Surgery
Gastroenterology
Health Evidence
Operating Rooms
Former Organization
Epidemiology, Biostatistics & HTA
Journal title
Colorectal Disease
Volume
vol. 15
Issue
iss. 6
Page start
p. e323
Page end
p. e329
Subject
IGMD 2: Molecular gastro-enterology and hepatology; IGMD 2: Molecular gastro-enterology and hepatology N4i 1: Pathogenesis and modulation of inflammation; NCEBP 2: Evaluation of complex medical interventions; NCEBP 2: Evaluation of complex medical interventions ONCOL 4: Quality of Care; NCMLS 2: Immune RegulationAbstract
AIM: Restorative surgery after (procto)colectomy with ileo-neorectal anastomosis (INRA) or restorative proctocolectomy with ileal pouch anal anastomosis (RPC) combines cure of ulcerative colitis (UC) with restoration of intestinal continuity. This study aimed to evaluate these two operations. METHOD: Patients having INRA and RPC were matched according to sex, age at onset of UC, age at restorative surgery and duration of follow-up. Patients were included if they were over 18 years of age, had UC confirmed histopathologically and had undergone either operation. Long-term function, anal and neorectal physiology, complications, quality of life (QoL) and health status (HS) were determined. RESULTS: Seventy-one consecutive patients underwent surgery with the intention of having an INRA procedure. This was successfully carried out in 50, and 21 underwent intra-operative conversion to RPC. Median defaecation frequency was 6/24 h. In 11/71 patients reservoir failure occurred and 13/71 developed pouchitis. QoL and HS were comparable to the healthy population. Median follow-up was 6.2 years. These patients were matched with 71 patients who underwent RPC. RPC was successful in all patients. Median defaecation frequency was 8/24 h. Failure occurred in 7/71 patients and 13/71 developed pouchitis. QoL and HS were comparable with the healthy population. Median follow-up was 6.9 years. CONCLUSION: Comparison of INRA and RPC on an intention to treat basis was not considered to be realistic due to the high intra-operative conversion rate and the failures in the INRA group. RPC remains the procedure of choice for restoring intestinal continuity after proctocolectomy for UC.
This item appears in the following Collection(s)
- Academic publications [244262]
- Electronic publications [131202]
- Faculty of Medical Sciences [92892]
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