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

  • Olga A. Lavryk
  • Luca Stocchi
  • Tracy L. Hull
  • Emre Gorgun
  • Sherief Shawki
  • Jeremy M. Lipman
  • Stefan D. Holubar
  • Conor P. Delaney
  • Scott R. Steele
Original Article
  • 14 Downloads

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.

Keywords

Ileal pouch anal anastomosis Quality of life Inflammatory bowel disease 

Notes

Author’s Contribution

All authors participated in conception and design of the study, acquisition of data, analysis and interpretation of data, drafting and revising the manuscript, approval of the published version.

Compliance with Ethical Standards

Disclosure

None.

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Copyright information

© The Society for Surgery of the Alimentary Tract 2018

Authors and Affiliations

  1. 1.Department of Colorectal SurgeryCleveland ClinicClevelandUSA

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