Ileal pouch-anal anastomosis for ulcerative colitis: complications and long term functional results

The ileo anal-pouch-anastomosis (IPAA) is the treatment of choice for patients with ulcerative colitis (UC). To analyze the surgical outcomes, long term evolution and functional results of IPAA. All patients subjected to an IPAA, from 1984 to 2006 were identified from a prospectively constructed inf...

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Veröffentlicht in:Revista medíca de Chile 2008-04, Vol.136 (4), p.467-474
Hauptverfasser: Zárate C, Alejandro, Zúñiga D, Alvaro, Pinedo M, George, López K, Francisco, Molina P, María E, Viviani G, Paola
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container_start_page 467
container_title Revista medíca de Chile
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creator Zárate C, Alejandro
Zúñiga D, Alvaro
Pinedo M, George
López K, Francisco
Molina P, María E
Viviani G, Paola
description The ileo anal-pouch-anastomosis (IPAA) is the treatment of choice for patients with ulcerative colitis (UC). To analyze the surgical outcomes, long term evolution and functional results of IPAA. All patients subjected to an IPAA, from 1984 to 2006 were identified from a prospectively constructed inflammatory bowel disease database. Surgical variables, postoperative complications and functional evaluation, using Oresland score were analyzed. Chi square, Fischer exact test, T Student, Mann Whitney and binary logistic regression were included in the statistical analysis. In the study period 107 patients, aged 14 to 62 years (61 females), subjected to an IPAA, were identified in this period. All patients, except 4, had a J pouch. All were protected with a loop ileostomy. Thirteen patients (12.1%) had specific postoperative complications: pelvic collections in five (4.6%), wound infection in four (3.7%), fistula of the anastomosis in two (1.8%), hemoperitoneum and pouch necrosis in one each. Three (2.7%) patients were reoperated. There was no post-operative (30 days) mortality. A complete follow-up was obtained in 106 of 107 patients: four evolved as Crohn disease; four lost their pouch and two died for other causes. One patient required an ileostomy due to a vaginal fistula. Seventy two patients were followed more than 36 months after ileostomy closure and 92% have a satisfactory intestinal function. In the univariate analysis, poorest intestinal function was related to age of diagnosis of UC and presence of chronic pouchitis. In the multivariate analyses age of diagnosis was associated with poor function. IPAA has a low rate of complications. The long term intestinal function is satisfactory in most patients. A poorer intestinal function was observed in older patients and those with chronic pouchitis).
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To analyze the surgical outcomes, long term evolution and functional results of IPAA. All patients subjected to an IPAA, from 1984 to 2006 were identified from a prospectively constructed inflammatory bowel disease database. Surgical variables, postoperative complications and functional evaluation, using Oresland score were analyzed. Chi square, Fischer exact test, T Student, Mann Whitney and binary logistic regression were included in the statistical analysis. In the study period 107 patients, aged 14 to 62 years (61 females), subjected to an IPAA, were identified in this period. All patients, except 4, had a J pouch. All were protected with a loop ileostomy. Thirteen patients (12.1%) had specific postoperative complications: pelvic collections in five (4.6%), wound infection in four (3.7%), fistula of the anastomosis in two (1.8%), hemoperitoneum and pouch necrosis in one each. Three (2.7%) patients were reoperated. There was no post-operative (30 days) mortality. 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subjects Adolescent
Adult
Anal Canal - surgery
Anastomosis, Surgical - adverse effects
Colitis, Ulcerative - surgery
Colonic Pouches - adverse effects
Crohn Disease - etiology
Female
Humans
Male
Middle Aged
Pouchitis - etiology
Preoperative Care
Proctocolectomy, Restorative - adverse effects
Surgical Wound Infection - etiology
Time Factors
Treatment Outcome
Young Adult
title Ileal pouch-anal anastomosis for ulcerative colitis: complications and long term functional results
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