Results at up to 20 years after ileal pouch-anal anastomosis for chronic ulcerative colitis
Results at up to 20 years after ileal pouch-anal anastomosis for chronic ulcerative colitis
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DOI：
10.1002/bjs.5464
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发表时间：
2007-03-01
影响因子：
9.6
通讯作者：
Dozois, R. R.
中科院分区：
文献类型：
--
作者：
Hahnloser, D.;Pemberton, J. H.;Dozois, R. R.
背景资料：回肠贮袋肛门吻合术（IPAA）进行常规慢性溃疡性colis.Methods：使用数据从前瞻性数据库和年度标准化问卷调查，功能结果，并发症和生活质量（QoL）后IPAA进行了assessed.Results：一些1885 IPAA手术进行慢性溃疡性结肠炎超过20年的时间（平均随访11年）。IPAA时的平均年龄为34.1岁，从31.2岁（1981-1985年）增加到36.3岁（1996-2000年）。5年、10年、15年和20年时的总体贮袋成功率分别为96.3%、93.3%、92.4%和92.1%。平均日间排便次数从1年时的5.7次增加到20年时的6.4次（P < 0.001），夜间排便次数也增加（从1.5次增加到2.0次; P < 0.001）。频繁的日间大便失禁的发生率在白天从5%增加到11%（P < 0.001），在夜间从12%增加到21%（P < 0.001）。生活质量保持不变，92%的人仍然从事同样的工作。76例患者最终被诊断为不确定性结肠炎和47克罗恩病。结论：IPAA是一个可靠的手术方法，为患者需要直肠结肠切除术慢性溃疡性结肠炎和不确定性结肠炎。术后20年临床和功能结果良好且稳定。
Background: Ileal pouch-anal anastomosis (IPAA) is performed routinely for chronic ulcerative colitis.Methods: Using data from a prospective database and annual standardized questionnaires, functional outcome, complications and quality of life (QoL) after IPAA were assessed.Results: Some 1885 IPAA operations were performed for chronic ulcerative colitis over a 20-year period (mean follow-up 11 years). The mean age at the time of IPAA was 34.1 years, increasing from 31.2 years (1981-1985) to 36.3 years (1996-2000). The overall rate of pouch success at 5, 10, 15 and 20 years was 96.3, 93.3, 92.4 and 92.1 per cent respectively. Mean daytime stool frequency increased from 5.7 at 1 year to 6.4 at 20 years (P < 0.001), and also increased at night (from 1.5 to 2.0; P < 0.001). The incidence of frequent daytime faecal incontinence increased from 5 to 11 per cent during the day (P < 0.001) and from 12 to 21 per cent at night (P < 0.001). QoL remained unchanged and 92 per cent remained in the same employment. Seventy-six patients were eventually diagnosed with indeterminate colitis and 47 with Crohn's disease.Conclusion: IPAA is a reliable surgical procedure for patients requiring proctocolectomy for chronic ulcerative colitis and indeterminate colitis. The clinical and functional outcomes are excellent and stable for 20 years after operation.