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10.08.2018 | Original Article | Ausgabe 3/2019

Journal of Gastrointestinal Surgery 3/2019

Factors Associated with Long-Term Quality of Life After Restorative Proctocolectomy with Ileal Pouch Anal Anastomosis

Zeitschrift:
Journal of Gastrointestinal Surgery > Ausgabe 3/2019
Autoren:
Olga A. Lavryk, Luca Stocchi, Tracy L. Hull, Emre Gorgun, Sherief Shawki, Jeremy M. Lipman, Stefan D. Holubar, Conor P. Delaney, Scott R. Steele
Wichtige Hinweise
State: Podium Presentation at American College of Surgeons, San Diego, CA 2017

Abstract

The aim

The aim of this study was to analyze factors associated with quality of life (QoL) after ileal pouch anal anastomosis (IPAA).

Methods

Patients who underwent IPAA (1983–2015) and replied to QoL questionnaire were identified from an IRB-approved prospectively maintained IPAA-database. QoL was assessed using Cleveland Global Quality of Life (CGQL) questionnaire at 1, 3, 5, and 10 years postoperatively. Patient cohort was divided in two groups: overall QoL score ≤ 0.7 (low) and > 0.7 (high). Demographics, perioperative morbidity, and functional results were analyzed.

Results

A total of 4059 patients replied to the questionnaire at the most recent follow-up and were included. A total of 2889 (71%) had overall QoL > 0.7 (group 1) and 1170 (29%) patients had overall QoL ≤ 0.7 (group 2). Patients in group 1 had lower rates of early (44.6 vs. 50.4%, p = 0.003) and late (55.7 vs. 64.5%, p < 0.003) postoperative complications. Kaplan-Meier survival analysis demonstrated significantly higher rates of pouch failure among patients with lower QoL. Pouchitis, obstruction, fistulas, higher number of stools, and IPAA performed during the most recent decade (2005–2015) were significantly associated with lower QoL (≤ 0.7), while S-pouch configuration was associated with higher QoL (> 0.7).

Conclusion

Patient’s characteristics and minimal perioperative complications impact patient’s QoL following IPAA not only in the short term, but also in the long term.

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