Table of Contents
ISRN Gastroenterology
Volume 2011 (2011), Article ID 625842, 10 pages
http://dx.doi.org/10.5402/2011/625842
Clinical Study

Long-Term Followup with Evaluation of the Surgical and Functional Results of the Ileal Pouch Reservoir in Restorative Proctocolectomy for Ulcerative Colitis

1Department of Surgery, Akershus University Hospital, N-1478 Lørenskog, Norway
2Faculty of Medicine, University of Oslo, 0316 Oslo, Norway
3Department of Gastrointestinal surgery, Akershus University Hospital, N-1478 Lørenskog, Norway
4Department of Surgery, Diakonissehjemmet Hospital, Haraldsplass, 5021 Bergen, Norway
5Department of Surgery, Haukeland University Hospital, 5021 Bergen, Norway
6Centre for Clinical Research, Haukeland University Hospital, 5021 Bergen, Norway
7Research Group on Lifestyle Epidemiology, Department of Public Health and Primary Health Care, University of Bergen, 5020 Bergen, Norway
8Department of Pathology, Ulleval University Hospital, 0424 Oslo, Norway

Received 28 March 2011; Accepted 20 April 2011

Academic Editors: D. C. Bartolo and J. M. Pajares

Copyright © 2011 Ola Røkke et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Aims. Evaluate the early and long term surgical and functional results of the ileal pouch-reservoir (IPAA) in patients with intractable ulcerative colitis. Material and Methods. Followup of 134 consecutive patients with W-or J-ileal pouch by diseases-specific and general health (SF-36) questionnaire. In the first 44 patients, early and late followup was performed. Results. Followup was performed 7.4 years (0.5–17 years) after construction of W ( 𝑛 = 9 ) and J ( 𝑛 = 1 2 5 ) ileal pouch, which had similar results. There were 14.9% early and 43.6% late complications with 12.7% early and 19.5% late reoperations. Protecting loop-ileostomy used in 54 patients (43.9%), did not protect against complications. Thirteen reservoirs (9.8%) were resected ( 𝑛 = 8 ) or deactivated ( 𝑛 = 5 ) due to functional failure. Operation time, postoperative complications and pouchitis were determinators for reservoir failure and reduced quality of life. The functional results at followup of 44 patients at 2.5 years (0.8–6.7 years) and 11.5 years (8.2–19.2 years) were remarkably similar. Conclusions. IPAA is a good option for most patients when medication fails. 10% experience failure with inferior quality of life. Protective stoma will not reduce failure rates. After an initial time period, reservoir function will not change over time.