Dr H Dieter, Dr John Pemberton and Dr Bruce Wolff undertook this study in order to evaluate in what manner ageing affects functional outcome and quality of life (QoL) in patients with chronic ulcerative colitis (CUC) after ileal pouch-anal anastomosis (IPAA).
Previous data had shown that short-term function and QoL after IPAA is good.
However, the patients included in these studies are usually young, and therefore little is known about the influence of time and ageing on long-term outcomes after IPAA.
| These data show that IPAA is a durable operation for patients requiring proctocolectomy for CUC|
|Annals of Surgery|
In this prospective study, the researchers distributed a standardized questionnaire to a cohort of 409 patients in order to assess functional outcome, QoL, and associated complications.
These patients were studied up to 15 years after their IPAA.
Follow-up was complete in the single cohort of 409 patients and functional and QoL outcomes summarized at 5, 10, and 15 years.
The researchers found that daytime stool frequency changed little (mean 6), while nighttime frequency increased from 1 stool to 2 stools.
The group also noted that incontinence for gas and stool increased from 1% to 10% during the day and from 2% to 24% at night over 15 years.
Analysis of the data showed that the cumulative probability of pouchitis increased from 28% at 5 years to 38% at 10 years and to 47% at 15 years.
Bowel obstruction and stricture were other principal long-term complications.
Quality of life outcomes were good, with the data showing that at 15 years, 91% of patients had kept the same job. Work was not affected by the surgery in 83%, while social activities, sports, traveling, and sexual life all improved after surgery and did not deteriorate over time.
Dr Dieter commenting on the group's findings said, "These long-term results in IPAA patients are unique and are likely a more accurate reflection of long-term outcome than has been previously reported".
He concluded, "These data show that IPAA is a durable operation for patients requiring proctocolectomy for CUC; functional and QoL outcomes are good, predictable, and stable for 15 years after operation."