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Pouch design and long-term functional outcome after ileal pouch-anal anastomosis.
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- Block, Mattias, 1968 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för kirurgi,Institute of Clinical Sciences, Department of Surgery
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- Börjesson, Lars, 1963 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för kirurgi,Institute of Clinical Sciences, Department of Surgery
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- Lindholm, Elisabet, 1946 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för kirurgi,Institute of Clinical Sciences, Department of Surgery
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- (creator_code:org_t)
- 2009-04-08
- 2009
- English.
- In: The British journal of surgery. - : Oxford University Press (OUP). - 1365-2168 .- 0007-1323. ; 96:5, s. 527-32
- Journal article (peer-reviewed)
Abstract
Subject headings
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- BACKGROUND: Functional outcome is of utmost importance after ileal pouch-anal anastomosis. Although pouch design and construction of the anastomosis are known technical determinants of function, there are few long-term results. This retrospective study evaluated functional outcome for two different pouch designs, and for handsewn versus stapled pouch-anal anastomoses. METHODS: The analysis included 412 patients who had either a J or K pouch (double-folded J pouch), of whom 123 had a J pouch (96 handsewn and 27 stapled) and 289 had a K pouch (95 handsewn and 194 stapled). Functional outcome was evaluated by a mailed questionnaire to achieve an Oresland score (0 to 15; 15 worst). RESULTS: Mean functional scores were 6.1 for J pouches and 4.9 for K pouches (P < 0.001). Regression analysis showed that reservoir design and age at surgery were predictors of functional outcome (P < 0.001). A higher proportion of patients with a J pouch and handsewn anastomosis than with a K pouch and stapled anastomosis had a score of 8 or more, a level previously demonstrated to impact negatively on quality of life (32 versus 16 per cent; P = 0.006). CONCLUSION: The K pouch was associated with a better long-term functional outcome than the J pouch in this patient population.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Keyword
- Adolescent
- Adult
- Aged
- Anal Canal
- surgery
- Anastomosis
- Surgical
- Colonic Diseases
- physiopathology
- surgery
- Colonic Pouches
- physiology
- Defecation
- physiology
- Fecal Incontinence
- etiology
- Female
- Humans
- Male
- Middle Aged
- Postoperative Complications
- etiology
- Prosthesis Design
- Surgical Stapling
- Suture Techniques
- Treatment Outcome
- Young Adult
Publication and Content Type
- ref (subject category)
- art (subject category)
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