Ileal pouch–anal anastomosis (IPAA) surgery as treatment for ulcerative colitis (UC) met the expectations of disease cure, maintaining adequate long-term intestinal functionality associated with a good quality of life, according to a study published in International Journal of Colorectal Disease.
Carcamo and colleagues used an email survey to assess long-term functional outcomes and quality of life of patients who underwent IPAA and had more than 10 years of follow-up between 1984 and 2017. The survey used the Öresland score and the Cleveland Global Quality of Life scales, respectively, for the outcomes interest.
In total, 116 patients were included in the study with a median follow-up of 20 (range, 10-34) years. Approximately 16% of patients had early postoperative complications, and over half of the cohort (56.9%) experienced adverse events. The IPAA preservation rate was 96.5% at 10 years and 93.1% at 20 years.
For the long-term functional scores, 78 surveys were sent, and the response rate was 70.5% (55/78). The median Öresland score was 6 (range, 1-15) points. IPAA functionality was reported as satisfactory in 20% of patients, acceptable in 32.7%, and deficient in 47.3%.
The median score was 0.8 (range, 0.23-1.0) points for global quality of life and, more specifically, 8 (3-10) points for quality of life, 8 (2-10) points for quality of health, and 8 (2-10) points for energy level. A large majority of patients (92.7%) reported being satisfied with the decision to have the procedure and would recommend it to other patients with UC who could benefits from surgical treatment.
Limitations of the study included the retrospective design and the possibility of underestimating postoperative complications and adverse events. The authors acknowledged that the assessments sampled patients at different points in time relative to their surgery (a span of 33 years), which could have influenced the results.
“In conclusion, in this series, IPAA surgery as treatment for UC [met] the expectations of cure of the disease, maintaining adequate long-term intestinal functionality associated with a good quality of life in most patients,” wrote the authors.
Carcamo L, Miranda P, Zúñiga A, et al. Ileal pouch–anal anastomosis in ulcerative colitis: outcomes, functional results, and quality of life in patients with more than 10-year follow-up [published online February 18, 2020]. Int J Colorectal Dis. doi: 10.1007/s00384-020-03529-7