Long-term follow-up after ileoanal pouch procedure

Heuschen, U.; Autschbach, Frank; Allemeyer, E. H.; Zöllinger, Anja; Heuschen, G.; Uehlein, T.; Herfarth, Ch.; Stern, J.

doi:10.1007/bf02234320

Cited by 131 publications

(27 citation statements)

References 54 publications

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“…Acute pouchitis was more frequent (21.3%) than chronic pouchitis (4.9%), as described by others 22,24,25 . Penna et al 21 reported a cumulative risk of developing pouchitis 1, 2, 5, and 10 years after IPAA of 16%, 23%, 36%, and 46%, respectively.…”

supporting

confidence: 55%

“…Luukkonen et al 22 found a cumulative risk of 50% at 4 years and a 7 % at 6 years. Heuschen et al 24 reported a cumulative risk of 50% of pouchitis at 8 years after IPAA. Yu et al 26 found after 10 years of follow-up an overall incidence of any complication of 48%, 50% of these due to pouchitis.…”

mentioning

confidence: 99%

“…There is still the risk of neoplastic transformation in the pouch, mainly in cases of chronic pouchitis 27,28 or in the remaining anal mucosa. Ileal pouchanal anastomosis requires regular surveillance 24 . A anastomose íleo-anal com reservatório ileal foi um importante avanço no tratamento da retocolite ulcerativa.…”

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Short- and long-term outcomes of ileal pouch-anal anastomosis for ulcerative colitis

et al. 2003

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Ileal pouch-anal anastomosis was an important advancement in the treatment of ulcerative colitis. The aim of this study was to determine whether early complications of ileal pouch-anal anastomosis in patients with ulcerative colitis are associated with poor late functional results. PATIENTS AND METHODS:Eighty patients were operated on from 1986 to 2000, 62 patients with ileostomy and 18 without. The early and late complications were recorded. Specific emphasis has been placed on the incidence of pouchitis with prolonged follow-up. RESULTS:The ileostomy was closed an average of 9.2 months after the first operation. Fourteen patients were excluded from the long-term evaluation; 6 patients were lost to regular follow-up, 4 died, and 4 patients still have the ileostomy. Of the 4 patients that died, 1 died from surgical complications. Early complications after operation (41) occurred in 34 patients (42.5%). Late complications (29) occurred in 25 patients as follows: 16 had pouchitis, 3 associated with stenosis and 1 with sexual dysfunction; 5 had stenosis; and there was 1 case each of incisional hernia, ileoanal fistula, hepatic cancer, and endometriosis. Pouchitis occurred in 6 patients (9.8%) 1 year after ileal pouch-anal anastomosis, 9 (14.8%) after 3 years, 13 (21.3%) after 5 years, and 16 (26.2%) after more than 6 years. The mean daily stool frequency was 12 before and 5.8 after operation. One pouch was removed because of fistulas that appeared 2 years later.CONCLUSIONS: Ileal pouch-anal anastomosis is associated with a considerable number of early complications. There was no correlation between pouchitis and severe disease, operation with or without ileostomy, or early postoperative complications. The incidence of pouchitis was directly proportional to duration of time of follow-up.

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confidence: 55%

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confidence: 99%

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Short- and long-term outcomes of ileal pouch-anal anastomosis for ulcerative colitis

et al. 2003

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“…The incidence of pouchitis in adult UC patients reportedly ranges between 15% and 18% during the first year after ileostomy closure, reaching 48% by the tenth postoperative year [17, 18]. The first episode is observed within 1 year after ileostomy closure in 70% of patients with pouchitis [19].…”

Section: Discussionmentioning

confidence: 99%

Functional Outcomes and Quality of Life after Restorative Proctocolectomy in Paediatric Patients: A Case-Control Study

Pellino

Sciaudone

Miele

et al. 2014

Gastroenterology Research and Practice

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Background. Restorative proctocolectomy with ileal-pouch anal anastomosis (IPAA) has some peculiarities in paediatric ulcerative colitis (UC). Aims. The primary aim was to compare the bowel function of patients undergoing IPAA between those operated on in childhood and adulthood. The secondary aim was to compare the quality of life (QoL) and outcomes for children between medical and surgical therapies. Method. Children undergoing IPAA were compared with adult patients undergoing IPAA between 2007 and 2012. Function was assessed 1 year after ileostomy closure. Function and QoL of medically managed paediatric patients were compared with their surgical counterparts. Results. Twelve paediatric IPAA patients were compared with 24 adult ones. Acute presentation was common in the former, usually after failed biological treatment. Recurrent pouchitis was more frequent in children. Younger patients exhibited a trend toward better discrimination and continence. QoL was excellent in both groups. Twelve medically treated children were enrolled for secondary aim. Functioning was similar in IPAA- and medically managed children, but the former had a better QoL, confirmed by parents' perception. Conclusions. Similar function is achieved by IPAA in childhood or adulthood. IPAA may offer a better QoL compared to prolonged medical management. The beneficial effects of IPAA experienced by children were similarly observed by their parents.

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“…Thereafter, patients are examined 3, 6 and 12 months after IPAA, followed by annual control investigations for the next 4 years, then once every 2 years [35].…”

Section: Follow-up Investigations After Ipaamentioning

confidence: 99%

Surgical Treatment of Severe Inflammatory Bowel Diseases

Leowardi

Heuschen²,

Kienle³

et al. 2003

Dig Dis

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Surgical treatment of severe inflammatory bowel diseases is required in failed medical treatment, in emergencies and for complications. Indications for surgery and operative techniques have changed significantly over the last few years. There is a clear tendency towards earlier and less invasive surgical interventions performed in specialized and experienced centers. Improved quality of life of patients with Crohn’s disease or ulcerative colitis after surgical therapy supports an earlier consideration of the surgical treatment option. A close cooperation with the involved gastroenterologist is mandatory in this context.

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Long-term follow-up after ileoanal pouch procedure

Cited by 131 publications

References 54 publications

Short- and long-term outcomes of ileal pouch-anal anastomosis for ulcerative colitis

Short- and long-term outcomes of ileal pouch-anal anastomosis for ulcerative colitis

Functional Outcomes and Quality of Life after Restorative Proctocolectomy in Paediatric Patients: A Case-Control Study

Surgical Treatment of Severe Inflammatory Bowel Diseases

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