Marie Louise Sunde1,2, Tom Øresland1,2, Arne E. Færden2
1University of Oslo, Faculty of Medicine 2Akershus University Hospital, Department of Surgery
Background and aim
Ileal pouch-anal anastomosis (IPAA) is the treatment of choice in patients with ulcerative colitis (UC) or familial adenomatous polyposis (FAP) in need of surgery. The objective of this study was to report surgical-/ functional outcome and quality of IPAA surgery with two different pouch designs.
Patients having undergone IPAA surgery from 2000 and had their loop-ileostomy closed within June 2013 were identified from medical record files. They were sent a quality of life-questionnaire and interviewed utilising a pouch function score (PFS) according to Oresland (0-16, higher scores worse function).
Altogether 103 were operated (47 with J-pouch, 47 with K-pouch). None have had their pouch removed/defunctioned due to failure. Mean follow-up was eight years. Reoperation rate was 10.7%. Mean PFS was 5.4 in J, and 5.2 in K (p=0.766). Significantly more patients with J-pouch reported a social handicap due to bad bowel function (p=0.041). Patients with a PFS ≥ 8 had poorer quality of life. Among K-patients 16% reported PFS ≥ 8, 25% of J-patients had PFS ≥ 8.
When treating patients in a well established multidisciplinary setting IPAA is a safe procedure with low complication rate and good functional outcome. Although J pouch is most commonly used, there might be better options. Small improvements in functional outcome have an impact on patient’s quality of life.