The first 2 authors contributed equally to the article.
Outcome after proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis
Article first published online: 31 OCT 2007
Copyright © 2007 Crohn's & Colitis Foundation of America, Inc.
Inflammatory Bowel Diseases
Volume 14, Issue 1, pages 20–28, January 2008
How to Cite
Ferrante, M., Declerck, S., De Hertogh, G., Van Assche, G., Geboes, K., Rutgeerts, P., Penninckx, F., Vermeire, S. and D'Hoore, A. (2008), Outcome after proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis. Inflamm Bowel Dis, 14: 20–28. doi: 10.1002/ibd.20278
- Issue published online: 10 DEC 2007
- Article first published online: 31 OCT 2007
- Manuscript Accepted: 3 AUG 2007
- Manuscript Received: 18 JUN 2007
- ulcerative colitis;
Background: During the course of their disease, about 30% of patients with ulcerative colitis (UC) will undergo proctocolectomy with ileal pouch-anal anastomosis (IPAA). We evaluated the outcome of IPAA in a Belgian referral center.
Methods: Clinical charts were reviewed for pre- and postoperative disease course, functional outcome, and complications in all patients with UC (n = 182) and indeterminate colitis (n = 2) who underwent IPAA in 1990–2004.
Results: Follow-up data were available in 173 out of 184 patients (67 female, median age at proctocolectomy 39.0 years). Median functional Öresland score 1 year after IPAA was 3 (range 0–11). Early postoperative complications were seen in 27% of patients. After a median (interquartile range) follow-up of 6.5 (3.4–9.9) years, 35% of patients developed septic and/or obstructive complications. Forty-six percent of patients developed at least 1 episode of pouchitis. Risk factors for pouchitis were the presence of extraintestinal manifestations (odds ratio [OR] 1.92 (1.23–3.01), P = 0.004) and younger age at proctocolectomy (P = 0.004). Chronic pouchitis was present in 33 patients and associated with extraintestinal manifestations (OR 2.93 (1.13–7.62), P = 0.027), backwash ileitis (OR 9.28 (1.71–50.49), P = 0.010), and length of follow-up (P = 0.004). Pouch failure occurred in 5% of patients.
Conclusions: Although proctocolectomy with IPAA surgery has a good functional outcome, postoperative complications, especially pouchitis, remain considerable in patients with UC.
(Inflamm Bowel Dis 2007)