Assessment of Age in Ulcerative Colitis Patients with Ileal Pouch Creation—An Evaluation of Outcomes

Abstract

Introduction: The aim of the study was to determine if age at the creation of an ileal pouch-anal anastomosis (IPAA) has an impact on the outcomes in patients with ulcerative colitis (UC). Materials and Methods: A retrospective review of all patients who underwent IPAA for UC from 1999 to 2011 was performed. Long-term functional outcome was assessed using both the Cleveland Clinic and St Mark’s incontinence scores. Results: Eighty-nine patients, with a median age of 46 (range, 16 to 71) years, formed the study group. The median duration of disease prior to their pouch surgery was 7 (0.5 to 39) years. There were 57 (64%) patients who were aged ≤50 years old and 32 (36%) who were >50 years old. Fifty-seven (64%) patients developed perioperative complications of which 51 (89.5%) were minor. High ileostomy output (n = 21, 23.6%) and urinary symptoms (n = 13, 14.6%) were the most commonly encountered complications. The older patients were more likely to have an ASA score ≥3 and a longer length of stay. Although there was a higher incidence of complications in the older group of patients, the difference was not statistically significant. There were no significant differences in the incidence of severe complications. Forty-nine (55%) patients completed our questionnaire on the evaluation of their functional outcomes. There were no significant differences in the Cleveland Clinic and St Mark’s incontinence scores between the older (n = 19, 38.8%) and younger (n = 30, 61.2%) patients. There were also no significant differences in the frequency of bowel movements during the day or overnight after sleep between the 2 groups. Conclusion: IPAA procedure for patients with UC can be safely performed. Long-term functional outcome is not significantly influenced by the age at which the IPAA was created. Key words: Continence, Function

Ileal pouch‐anal anastomosis provides good functional and quality of life outcomes following proctocolectomy: A 33‐year single centre experience

“…Late complications may include anal stricturing disease, SBO, anastomotic leaks, pelvic sepsis, pouchitis and pouch failure. 4,5 Sexual function (SF) and sexual restrictions post IPAA surgeries have paucity in the literature currently, although some QOL studies incorporate sexual restrictions as part of the QOL scores. The risk of sexual dysfunction is a reality in any form of pelvic surgery with potential damage to autonomic nerves during the proctectomy.…”

“…Morbidity with IPAA surgery includes early complications such as pouch leaks leading to pelvic and abdominal sepsis, small bowel obstruction (SBO), pouch fistula, wound infection and wound haemorrhage. Late complications may include anal stricturing disease, SBO, anastomotic leaks, pelvic sepsis, pouchitis and pouch failure 4,5 . Sexual function (SF) and sexual restrictions post IPAA surgeries have paucity in the literature currently, although some QOL studies incorporate sexual restrictions as part of the QOL scores.…”