TY - JOUR
T1 - Long-Term Outcome of IPAA in Patients Presenting with Fulminant Ulcerative Colitis
T2 - A Matched Cohort Study
AU - Fasen, Geoffrey S.
AU - Pandian, T. K.
AU - Pavey, Emily S.
AU - Dozois, Eric J.
AU - Boostrom, Sarah Y.
N1 - Publisher Copyright:
© 2015 Société Internationale de Chirurgie.
PY - 2015/10/1
Y1 - 2015/10/1
N2 - Background: Studies reveal that ileal pouch-anal anastomosis (IPAA) has long-term success. These reports, however, use well-selected cohorts and exclude patients presenting with fulminant colitis (FC). Herein, we aimed to characterize long-term functional outcomes in patients with fulminant ulcerative colitis (UC) undergoing IPAA. Methods: A prospective database identified patients who underwent IPAA between 1998 and 2008. Patients with FC and chronic UC were matched by age, gender, date of surgery, and follow-up duration. Clinical and laboratory parameters, immunomodulator use at the time of surgery, and functional outcomes were compared. Results: Forty patients with FC and 73 patients with chronic UC were identified. Preoperative albumin, hemoglobin, leukocyte count, and steroid dose were significantly different for those with FC. Average survey follow-up was 5.2 years for FC and 6.7 years for chronic UC patients. Functional outcomes were not significantly different. The 3-year fistula-free rate was 91.4 versus 98.6 % and the 3-year stricture-free rate was 79.3 versus 87.2 % for FC versus chronic UC patients, respectively. Conclusion: Patients undergoing colectomy for FC secondary to UC have similar long-term functional outcomes after IPAA despite significantly worse presentation. This study confirms that IPAA is an appropriate and durable treatment for patients with FC.
AB - Background: Studies reveal that ileal pouch-anal anastomosis (IPAA) has long-term success. These reports, however, use well-selected cohorts and exclude patients presenting with fulminant colitis (FC). Herein, we aimed to characterize long-term functional outcomes in patients with fulminant ulcerative colitis (UC) undergoing IPAA. Methods: A prospective database identified patients who underwent IPAA between 1998 and 2008. Patients with FC and chronic UC were matched by age, gender, date of surgery, and follow-up duration. Clinical and laboratory parameters, immunomodulator use at the time of surgery, and functional outcomes were compared. Results: Forty patients with FC and 73 patients with chronic UC were identified. Preoperative albumin, hemoglobin, leukocyte count, and steroid dose were significantly different for those with FC. Average survey follow-up was 5.2 years for FC and 6.7 years for chronic UC patients. Functional outcomes were not significantly different. The 3-year fistula-free rate was 91.4 versus 98.6 % and the 3-year stricture-free rate was 79.3 versus 87.2 % for FC versus chronic UC patients, respectively. Conclusion: Patients undergoing colectomy for FC secondary to UC have similar long-term functional outcomes after IPAA despite significantly worse presentation. This study confirms that IPAA is an appropriate and durable treatment for patients with FC.
UR - http://www.scopus.com/inward/record.url?scp=84957845608&partnerID=8YFLogxK
U2 - 10.1007/s00268-015-3114-5
DO - 10.1007/s00268-015-3114-5
M3 - Article
C2 - 26067636
AN - SCOPUS:84957845608
SN - 0364-2313
VL - 39
SP - 2590
EP - 2594
JO - World journal of surgery
JF - World journal of surgery
IS - 10
ER -