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Total proctocolectomy with IPAA is frequently considered the procedure of choice for surgical patients with ulcerative colitis, presumably owing to an expectation of improved quality of life in comparison with an ileostomy. Dr Kevin Kuruvilla and colleagues determined whether long-term quality of life among patients with a pelvic pouch is better than those who chose a permanent stoma. The team performed an investigation in a cross-sectional observational study using a prospective database at an academic medical center.  | | Patients with a pelvic pouch had better subscores in current quality of health | | Alimentary Pharmacology & Therapeutics |
Consecutive patients who had undergone IPAA or a permanent ileostomy for ulcerative colitis by a single surgeon, presenting for their annual follow-up visit in 2011 were offered participation in the study. A randomly chosen group of subjects who did not have scheduled appointments during the study period were sent a letter inviting them to participate in the study. The researchers' primary outcome measures used were EQ-5D-3L, the Short Quality of Life in Inflammatory Bowel Disease questionnaire, the Cleveland Global Quality of Life instrument, the Fecal Incontinence Quality of Life scale, and the Stoma Quality of Life scale. The team found that 35 patients with a pelvic pouch, and 24 ostomates were accrued and comprehensively studied. The researchers found that global quality-of-life scores were virtually identical for the 2 groups. Patients with a pelvic pouch had better subscores in current quality of health and energy level, Fazio score, sexuality/body image, and work/social function. Dr Kuruvilla's team commented, "Informed patients with ulcerative colitis choosing an ileostomy have a health-related global quality of life very similar to patients with a pelvic pouch." "Better outcomes in patients with an ileal pouch were most evident in the areas of sexuality/body image and work/social function."
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