Introduction Ileo-anal pouch formation is the preferred option for restoring continuity in patients post proctocolectomy. The aim of this study was to assess the long-term functional outcome of the W-pouch and its impact on the patient’s quality of life.
Method A consecutive series of 62 patients who had undergone restorative proctocolectomy with W ileo-anal pouch formation between 1995 and 2014 were sent questionnaires to assess the long-term functional outcome of the pouch and its effect on their quality of life (QOL). Patients had been operated on by a single surgeon using an identical technique. Patients were divided in to two groups: patients who have been living with a pouch for 10 years or more or those who have had a pouch for less than 10 years. The differences between both groups were analysed using the Mann-Whitney U test.
Results 38 out of 62 patients (61%) responded to the postal questionnaires. They were similar to the overall group in terms of gender, age, length of stay and indication for surgery.
Overall, 27 patients (71%) reported <5 bowel movements (BM)/day and nine (24%) reported no BM at night. 37 patients (97%) reported good or excellent continence. Only one patient had soiling either during day or night. 30 patients (79%) were able to defer defecation for >1 h. Anti-diarrhoea medication was needed daily by 15 patients (39%) or occasionally by seven patients (18%). A possible episode of pouchitis was reported by 13 patients (34%). 35 patients (92%) preferred a pouch to an ileostomy.
There was no difference in functional outcomes reported by those who had a pouch <10 years (20 patients) compared with those with a pouch >10 years (18 patients). QOL measures were also similar across both groups. However, anxiety levels were found to be higher in those with a pouch >10 years (p = 0.02).
Conclusion Patients with ileo-anal pouch anastomosis have a good quality of life and long-term pouch outcome, which does not deteriorate with time.
Disclosure of interest None Declared.
Perrin, A. Quality of life after ileo-anal pouch formation: patient perceptions. Br J Nurs. 2012;26(21):16
Andersson T, Lunde OC, Johnson E et al. Long-term functional outcome and quality of life after restorative proctocolectomy with ileo-anal anastomosis for colitis.Colorectal Dis. 2011;4:431–7
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