Is Ileoanal Pouch Function Stable with Time?

Abstract

Most patients have stable pouch function over time. However, a small number improve and a larger number suffer measurable deterioration, particularly 12 or more years after surgery.

Long-term outcome 10 years or more after restorative proctocolectomy and ileal pouch–anal anastomosis in patients with ulcerative colitis

“…In the present study, the median number of bowel movements was seven in 24 h, one of them occurring at night. These figures are consistent with other reports of large series [1,[12][13][14][15][16] describing stool frequencies between five and nine in 24 h after an initial period of adjustment lasting 12-18 months and remaining constant in the first decade after IPAA. In a recent meta-analysis, the mean defaecation frequency was 5.2 per 24 h with a mean nighttime frequency of 1.0 and a median follow-up of 37.2 months (range, 12-120) [4].…”

“…Fifteen of them filled in the questionnaire section on quality of life with a permanent ileostomy. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20], five at daytime (IQR, 4-7; range, 2-18) and one at night (IQR, 1-2; range, 0-8). Forty-three patients had eight or more stools per 24 h, whereas 131 had fewer defaecations.…”

Salvage surgery after restorative proctocolectomy

“…In a prospective study of patients over 12 years there was no change in bowel frequency, although there was an increase in major day continence in 18 per cent and improvement in 1 per cent of patients. Most patients had stable function over the 12 years 41 .…”

Bekkenreservoarkirurgi

“…Ved økende observasjonstid kan det bli flere med reservoarsvikt og dårligere funksjonelle resultater. Ut fra prospektive studier med lang observasjonstid (opp mot 20 år) er det også antydet en mulig tendens til dårligere funksjonelle resultater over tid, det gjelder da spesielt lekkasjeproblemer (5,16). Det samme er tilfellet for lokale komplikasjonerførst og fremst pouchitt, der man vet at forekomsten øker med økende observasjonstid (1,4,8,9,17).…”