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Comparative Study
. 2002 Jul;236(1):43-8.
doi: 10.1097/00000658-200207000-00008.

Equivalent function, quality of life and pouch survival rates after ileal pouch-anal anastomosis for indeterminate and ulcerative colitis

Conor P Delaney  1 , Feza H Remzi, Terry Gramlich, Babak Dadvand, Victor W Fazio
Affiliations
Comparative Study

Equivalent function, quality of life and pouch survival rates after ileal pouch-anal anastomosis for indeterminate and ulcerative colitis

Conor P Delaney et al. Ann Surg. 2002 Jul.

Abstract

Objective: To compare the function, complications, and quality of life after ileal pouch-anal anastomosis (IPAA) for patients with indeterminate colitis (IndC) and ulcerative colitis (UC).

Summary background data: Reports on the outcome of IPAA for IndC have been inconclusive because of the small numbers available for analysis. Concerns about functional outcome, infectious perineal complications, pouch loss and the development of Crohn's disease remain, while there is no data on the quality of life after IPAA for IndC.

Methods: One thousand nine hundred and eleven patients undergoing IPAA for Ind and UC from 1983 to 1999 were evaluated. IndC was confirmed by repeat pathologic evaluation in 115 patients. Functional outcome and quality of life were assessed prospectively for all office visits (IndC = 230; UC = 5388) using previously reported systems. Complications were evaluated retrospectively.

Results: Functional results and the incidence of anastomotic complications and major pouch fistulae were the same in UC and IndC patients. Although IndC patients were more likely to develop minor perineal fistulae, pelvic abscess, and Crohn's disease, the rate of pouch failure was 3.4%, identical to that of UC patients. There was no clinically significant difference in quality of life, or satisfaction with IPAA surgery. Patients were equally happy to recommend surgery to IndC or UC patients, but 3% fewer IndC would undergo the same surgery again for their disease.

Conclusions: While functional outcome, quality of life, and pouch survival rates are equivalent after IPAA for IndC and UC, there is an increase in some complications and the late diagnosis of Crohn's disease. Over 93% of IndC patients would undergo the same procedure again, and 98% would recommend IPAA to others with IndC. Patients with IndC should not be precluded from having IPAA surgery.

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References

    1. Lockhart-Mummery HE, Morson BC. Crohn’s disease (regional enteritis) of the large intestine and its distribution from ulcerative colitis. Gut 1960; 1: 87–105. - PMC - PubMed
    1. Marcello PW, Schoetz DJ, Roberts PL, et al. Evolutionary changes in the pathologic diagnosis after the ileoanal pouch procedure. Dis Colon Rectum 1997; 40: 263–9. - PubMed
    1. Price AB. Overlap in the spectrum of non-specific inflammatory bowel disease - “colitis indeterminate.” J Clin Pathol 1978; 31: 567–77. - PMC - PubMed
    1. Tanaka M, Riddell RH. The pathological diagnosis and differential diagnosis of Crohn’s disease. Hepatogastroenterology 1990; 37: 18–31. - PubMed
    1. Lee KS, Medline A, Shockey S. Indeterminate colitis in the spectrum of inflammatory bowel disease. Arch Pathol Lab Med 1979; 103: 173–6. - PubMed

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