This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Results at up to 20 years after ileal pouch–anal anastomosis for chronic ulcerative colitis. BJS 2007; 94: 333-340.
Published: 15th January 2007
Authors: D. Hahnloser, J. H. Pemberton, B. G. Wolff, D. R. Larson, B. S. Crownhart, R. R. Dozois et al.
Background
Ileal pouch–anal anastomosis (IPAA) is performed routinely for chronic ulcerative colitis.
Method
Using data from a prospective database and annual standardized questionnaires, functional outcome, complications and quality of life (QoL) after IPAA were assessed.
Results
Some 1885 IPAA operations were performed for chronic ulcerative colitis over a 20‐year period (mean follow‐up 11 years). The mean age at the time of IPAA was 34·1 years, increasing from 31·2 years (1981–1985) to 36·3 years (1996–2000). The overall rate of pouch success at 5, 10, 15 and 20 years was 96·3, 93·3, 92·4 and 92·1 per cent respectively. Mean daytime stool frequency increased from 5·7 at 1 year to 6·4 at 20 years (P < 0·001), and also increased at night (from 1·5 to 2·0; P < 0·001). The incidence of frequent daytime faecal incontinence increased from 5 to 11 per cent during the day (P < 0·001) and from 12 to 21 per cent at night (P < 0·001). QoL remained unchanged and 92 per cent remained in the same employment. Seventy‐six patients were eventually diagnosed with indeterminate colitis and 47 with Crohn's disease.
Conclusion
IPAA is a reliable surgical procedure for patients requiring proctocolectomy for chronic ulcerative colitis and indeterminate colitis. The clinical and functional outcomes are excellent and stable for 20 years after operation. Copyright © 2006 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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