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News

Outcomes after ileal pouch-anal anastomosis have improved

Modifications in surgical technique and surgical experience improve clinical outcome after ileal pouch-anal anastomosis, finds this month's Diseases of the Colon & Rectum.

News image

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Dr Kennedy and colleagues from Canada determined whether changes in length of stay for ileal pouch-anal anastomosis occurred over time, with changes in surgical technique and hospital volume.

The research team also assessed whether 30-day readmission, reoperation, and excision rates for the ileal pouch-anal anastomosis occurred over time.

The team evaluated 3 population-based administrative databases.

Data on all ileal pouch-anal anastomoses performed between 1992 and 1998 were obtained.

The effect of age, gender, stage of the procedure, year of surgery, and hospital volume were examined for their effect on length of stay and readmission, reoperation, and excision rates.

Patients younger than aged 40 years had a lower length of stay
Diseases of the Colon & Rectum

The researchers found that 1285 ileal pouch-anal anastomoses were performed in 58 hospitals.

There was a significant decrease in length of stay, and reoperation and excision rates.

However, there was a concommitant increase in readmission rate during the study period.

The team noted that patients younger than aged 40 years had a significantly lower length of stay and excision rate.

Patients who had a 2-stage procedure had a shorter length of stay, readmission, and reoperative rate compared with those having a 3-stage procedure.

The researchers observed that hospital volume was a significant predictor of need for reoperation.

Low-volume hospitals had significantly higher reoperation rates than high-volume hospitals.

Dr Kennedy's team comments, “Outcomes after ileal pouch-anal anastomosis has improved.”

“It is significantly better in patients younger than aged 40 years, having a 2-stage procedure, and where surgery is performed at high-volume hospitals.”

“It is likely that both modifications in surgical technique and surgical experience have led to improvements in clinical outcome after ileal pouch-anal anastomosis.”

Dis Col Rectum 2006: 49(7): 958-65
31 July 2006

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