Functional Outcome and Quality of Life After Restorative Proctocolectomy and Ileal Pouch-Anal Anastomosis in Elderly Patients

Jota, Gjorgji; Karadzov, Zoran; Panovski, Milco; Joksimović, N; Карталов, Андријан; Gelevski, Radomir; Joksimovic, Vladimir

doi:10.2478/v10283-012-0006-6

Cited by 3 publications

(13 citation statements)

References 21 publications

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“…Of the 13 studies, eight included UC [5,6,10,[15][16][17][18]20] patients alone and the other five included a combination of both UC and FAP patients [4,7,19,21,22]; only 4.4% of patients (95% CI 2.6%-7.2%) had FAP (Table 2). Nine studies reported both short-and long-term outcomes of IPAA [6,7,10,[16][17][18][20][21][22], one study reported only short-term outcomes of IPAA [5] and three studies focused only on long-term outcomes of IPAA [4,15,19] The mean pooled age of the patients included in the study was 64.3 years (95% CI 58.6-70.0 years) (Table 3). Sex was included in 12 studies, and 59.7% of patients were found to be male (52.7%−66.4%) (Table 2) [4][5][6][7]10,15,[17][18][19][20][21][22].…”

Section: Patient Demographicsmentioning

confidence: 99%

“…A subgroup analysis was performed to determine the heterogeneity of study outcomes with respect to the age of the patient population (50-65 years, ≥65 years; Table 4). Patients were divided using the mean age of each study's population into ages 50-65 years (n = 1124), [4,5,10,15,16,20,22] and ≥65 years (n = 136) [4,6,17,18,21]. The subgroup analysis revealed no significant difference in the rate of SBO between the 50-65 years (8.4%; 95% CI 1.8%-30.9%) and ≥65 years (9.4%; 95% CI 4.8%-17.8%) age groups.…”

Section: Short-term Outcomes (<30 Days)mentioning

confidence: 99%

“…Twelve studies reported incontinence rates [4,6,7,10,[15][16][17][18][19][20][21][22] (Figure 8). Forest plot analysis found statistically significant heterogeneity among all studies that included incontinence as a measure (p < 0.01).…”

Section: Ta B L E 3 Estimated Mean Of Continuous Variablesmentioning

confidence: 99%

“…However, the clinical question frequently arises about the appropriateness of IPAA in older and elderly patients given that many of the aforementioned studies have been limited by small sample sizes, heterogenous outcomes and only focus on either short-or long-term outcomes specifically. Moreover, most of these studies are limited to single-centre series [5,6,[9][10][11].…”

Section: Introductionmentioning

confidence: 99%

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Ileal pouch–anal anastomosis in the elderly: A systematic review and meta‐analysis

et al. 2021

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Aim: Despite good overall outcomes in most patients undergoing ileal pouch-anal anastomosis (IPAA), there is still hesitation about performing an IPAA in older patients due to the comorbidity burden and concern about incontinence. The aim of this work was to identify short-and long-term outcomes in older patinets undergoing IPAA to determine the perioperative safety and long-term functional success of IPAA in older patients.Method: A literature search was performed for all publications on IPAA in adults aged ≥50 years that reported short-and long-term outcomes. Data extraction included demographics, 30-day outcomes, long-term functional outcomes and pouch failure. Data were further separated by age group (50-65 and ≥65 years). Outcomes were compared between age groups. Study quality and risk of bias was assessed using the Newcastle-Ottawa Scale.Results: Of 1053 publications reviewed, 13 full papers were included in the analysis. The overall 30-day morbidity and mortality rates were 47.3% and 1.3%, respectively. Thirtyday postoperative rates of small bowel obstruction and pelvic sepsis were 7.6% and 9.9%, respectively. After a median follow-up time of 62 months, rates of pouchitis, incontinence and pouch failure were 13.9%, 17.5% and 7.5%, respectively. There was no statically significant difference in rates of short-or long-term functional outcomes based on age 50-65 versus ≥65 years. Conclusion:Increasing age did not increase the rate of short-or long-term outcomes, including pouch failure. These data suggest that the decision for IPAA construction should not be based on age alone.

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Section: Patient Demographicsmentioning

confidence: 99%

Section: Short-term Outcomes (<30 Days)mentioning

confidence: 99%

Section: Ta B L E 3 Estimated Mean Of Continuous Variablesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ileal pouch–anal anastomosis in the elderly: A systematic review and meta‐analysis

et al. 2021

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“…For restorative proctocolectomy, IPAA is a safe procedure with a low risk of morbidity. Patient satisfaction is high, and functional outcomes are typically positive [ 11 ]. Because proctocolectomy with IPAA restores bowel function and allows feces to flow via the anus, this surgical procedure is preferred by many healthcare professionals and patients.…”

Section: Introductionmentioning

confidence: 99%

Ileo-Anal Pouch Anastomosis and New Remedial Approaches for Ulcerative Colitis: A Review Article

Jankar¹,

Shrivastava²

2023

Cureus

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Ulcerative colitis (UC) causes diffuse friability and superficial wall degeneration that is accompanied by bleeding. UC, now recognized as a global illness, affects millions of people globally. The most effective treatment for UC is Ileal Pouch Anal Anastomosis (IPAA). Many medical experts and patients favor proctocolectomy with IPAA because it improves bowel function and allows feces to pass via the anus. Considering the most recent research, systematic reviews, statistical analysis, and recommendations, a selective literature search was carried out. The database used was PubMed. The current work provides a summary of surgical alternatives, results, and pre-and postoperative treatment for UC patients. In the course of their illness, about 30% of UC patients will need surgery. Due to its natural limitation to the colon and rectum, UC may mostly be treated surgically. The preferred surgical process is a restorative proctocolectomy with an IPAA. A 30% postoperative complication rate and a 0.1% death rate for this operation are both shown in large studies. One of the biggest things preventing UC from being successfully treated surgically is pouchitis. A long-run success rate of the pouch is >90% after 10 follow-ups, despite a significant surgical complication rate. For patients with UC to have the best possible outcome, extensive collaboration among the various specialties in the pre and postoperative context is crucial. In skilled centers, more than 90% of the total patients can eventually achieve a decent quality of life despite a 30% likelihood of early postoperative problems. UC patients may be cured with proctocolectomy, but there is a risk of morbidity that must be considered, especially in pediatric patients. As a result of advancements in our comprehension of the pathogenic mechanisms causing UC, new therapies have been proposed, the most significant change being the emergence of anti-tumor necrosis factor (TNF) medications.

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Quality of life in patients with ileal pouch for ulcerative colitis

Tilio

Arias

Camargo

et al. 2013

Journal of Coloproctology

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Introduction proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the standard surgical procedure for the treatment of ulcerative colitis (UC) and is associated with the prospect of cure. Experience gained over the years has demonstrated the occurrence of a high number of complications as well as bowel disorders that can compromise quality of life (QoL). Objective evaluate QoL in patients with IPAA for ulcerative colitis. Patients and methods the Inflammatory Bowel Disease Questionnaire (IBDQ) was used to assess QoL in patients with IPAA after its validation in Portuguese. Results thirty-one patients submitted to IPAA by the same group of professionals were evaluated. QoL was classified as regular in all domains evaluated (intestinal and systemic symptoms and emotional and social aspects). There were no differences in relation to gender, type of pouch or postoperative time. However, elderly patients showed a tendency toward lower scores. Having a professional activity was associated with higher scores in systemic symptoms and social aspects (p < 0.05). Patients with ileostomy showed lower values in the domains of systemic symptoms, emotional and social aspects (p <0.05). Conclusion in all domains assessed, patients with IPAA for UC had QoL classified as regular. Ileostomy and lack of professional activity negatively influenced QoL.

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Functional Outcome and Quality of Life After Restorative Proctocolectomy and Ileal Pouch-Anal Anastomosis in Elderly Patients

Cited by 3 publications

References 21 publications

Ileal pouch–anal anastomosis in the elderly: A systematic review and meta‐analysis

Ileal pouch–anal anastomosis in the elderly: A systematic review and meta‐analysis

Ileo-Anal Pouch Anastomosis and New Remedial Approaches for Ulcerative Colitis: A Review Article

Quality of life in patients with ileal pouch for ulcerative colitis

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