201. Outcome after proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis.
- Author
-
Ferrante M, Declerck S, De Hertogh G, Van Assche G, Geboes K, Rutgeerts P, Penninckx F, Vermeire S, and D'Hoore A
- Subjects
- Adult, Age Factors, Belgium epidemiology, Female, Humans, Male, Middle Aged, Postoperative Complications, Pouchitis epidemiology, Risk Factors, Treatment Outcome, Anastomosis, Surgical methods, Colitis, Ulcerative surgery, Colonic Pouches, Proctocolectomy, Restorative methods
- Abstract
Background: During the course of their disease, about 30% of patients with ulcerative colitis (UC) will undergo proctocolectomy with ileal pouch-anal anastomosis (IPAA). We evaluated the outcome of IPAA in a Belgian referral center., Methods: Clinical charts were reviewed for pre- and postoperative disease course, functional outcome, and complications in all patients with UC (n = 182) and indeterminate colitis (n = 2) who underwent IPAA in 1990-2004., Results: Follow-up data were available in 173 out of 184 patients (67 female, median age at proctocolectomy 39.0 years). Median functional Oresland score 1 year after IPAA was 3 (range 0-11). Early postoperative complications were seen in 27% of patients. After a median (interquartile range) follow-up of 6.5 (3.4-9.9) years, 35% of patients developed septic and/or obstructive complications. Forty-six percent of patients developed at least 1 episode of pouchitis. Risk factors for pouchitis were the presence of extraintestinal manifestations (odds ratio [OR] 1.92 (1.23-3.01), P = 0.004) and younger age at proctocolectomy (P = 0.004). Chronic pouchitis was present in 33 patients and associated with extraintestinal manifestations (OR 2.93 (1.13-7.62), P = 0.027), backwash ileitis (OR 9.28 (1.71-50.49), P = 0.010), and length of follow-up (P = 0.004). Pouch failure occurred in 5% of patients., Conclusions: Although proctocolectomy with IPAA surgery has a good functional outcome, postoperative complications, especially pouchitis, remain considerable in patients with UC.
- Published
- 2008
- Full Text
- View/download PDF