Functional and clinical results of patients who underwent an ileal pouch-anal anastomosis

Abstract

Aim: To evaluate the characteristics, early and late complications, outcomes, quality of life, and procedure-related problems in patients who underwent restorative proctocolectomy performed with the ileal pouch-anal anastomosis (IPAA) approach. Method: Twenty-two of the 26 patients who underwent IPAA from 2007 to 2019 were included. Data collected included demographic characteristics, surgical indications, operation types, histopathological diagnosis, early (<3 months) and late (≥3 months) postoperative complications, and functional outcomes. The Cleveland Global Quality of Life score was used to evaluate quality of life. Results: Ten (45.5%) participants had ulcerative colitis (UC) and 12 (54.5%) had familial adenomatous polyposis (FAP). Nineteen (86.4%) patients underwent a two-stage surgical procedure. Early post-operative complications were: ileus n=4 (18.2%); wound infection n=4 (18.2%); pelvic abscess n=3 (13.6%); and other complications n=5 (22.7%). Late complications were: pouchitis n=2 (9.1%); anastomotic stenosis n=2 (9.1%); and pouch dysfunction n=2 (9.1%). Additionally, six (27.3%) reported experiencing fluid incontinence, of whom four (18.2%) were using pads during the day, and the mean defecation frequencies were 4.3±2.4 during the day and 1.04±0.89 during the night. Half of the patients (50%) had complaints of sexual dysfunction. It was noticed that 2 of the patients (9.1%) were using antidiarrheal drugs and 1 patient (4.5%) became pregnant 2 times after the operation. Quality of life score was significantly higher in patients with FAP (0.85±0.13) compared to patients with UC (0.71±0.11). Conclusion: This procedure can be applied safely with low comorbidity and good functional outcomes in centers with high caseloads and thus sufficient experience.