scholarly journals Could Total Colectomy with Ileorectal Anastomosis Be an Alternative to Total Proctocolectomy with Ileal Pouch-Anal Anastomosis in Selected Ulcerative Colitis Patients?

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Francesco Tonelli ◽  
Carmela Di Martino ◽  
Francesco Giudici
Keyword(s):  
Quality Of Life ◽  
Ulcerative Colitis ◽  
Ileorectal Anastomosis ◽  
Bowel Function ◽  
Functional Results ◽  
Late Complications ◽  
Matched Pair ◽  
Total Proctocolectomy ◽  
Matched Pair Analysis

Purpose. To evaluate ileorectal anastomosis (IRA) in selected ulcerative colitis patients.Methods. Early and late complications after IRA and IPAA were investigated. Bowel function and quality of life were assessed. Functional and QoL studies were performed as a matched pair analysis, comparing 98 patients who underwent IRA versus 98 patients who underwent IPAA.Results. In IRA group, 2 patients (1.6%) developed anastomotic l dysplasia (HGD) developed in 3 patients dysplasia (HGD) developed in 3 patients eakage, 1 patient (0.8%) had intestinal obstruction, and 2 patients (1.6%) had abdominal hematoma. Mean follow-up was 11.5 (range: 2–24.3) years. Failure of IRA occurred in 19 patients (15.1%); in 12 patients (9.5%), failure was related to severe proctitis, in 3 patients (2.4%), it was related to the development of high-grade dysplasia, and in 4 patients (3.2%), it was related to the development of rectal cancer. About functional results, stool consistency [liquid (6.7% of IRA patients versus 29% of IPAA patients;p=0.003)], daily soiling (0% versus 6%;p=0.01), and nocturnal soiling (6% versus 25.5%;p=0.03) were statistically different. Only 1% of IRA patients versus 11% of IPAA patients had episodes of perianal inflammation (p=0.007). CGQoL was 0.72 (±0.14, SD) in IRA patients and 0.75 (±0.11, SD) in IPAA patients (p=ns).Conclusion. In selected patients, IRA is an appropriate surgical option, with low morbidity, comparable quality of life, and better functional results than IPAA.

scholarly journals Long-Term Followup with Evaluation of the Surgical and Functional Results of the Ileal Pouch Reservoir in Restorative Proctocolectomy for Ulcerative Colitis

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
Ola Røkke ◽  
Knut Iversen ◽  
Torill Olsen ◽  
Sølvi-Mai Ristesund ◽  
Geir Egil Eide ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ulcerative Colitis ◽  
Ileal Pouch ◽  
Loop Ileostomy ◽  
Operation Time ◽  
Functional Results ◽  
Late Complications ◽  
Initial Time

Aims. Evaluate the early and long term surgical and functional results of the ileal pouch-reservoir (IPAA) in patients with intractable ulcerative colitis. Material and Methods. Followup of 134 consecutive patients with W-or J-ileal pouch by diseases-specific and general health (SF-36) questionnaire. In the first 44 patients, early and late followup was performed. Results. Followup was performed 7.4 years (0.5–17 years) after construction of W () and J () ileal pouch, which had similar results. There were 14.9% early and 43.6% late complications with 12.7% early and 19.5% late reoperations. Protecting loop-ileostomy used in 54 patients (43.9%), did not protect against complications. Thirteen reservoirs (9.8%) were resected () or deactivated () due to functional failure. Operation time, postoperative complications and pouchitis were determinators for reservoir failure and reduced quality of life. The functional results at followup of 44 patients at 2.5 years (0.8–6.7 years) and 11.5 years (8.2–19.2 years) were remarkably similar. Conclusions. IPAA is a good option for most patients when medication fails. 10% experience failure with inferior quality of life. Protective stoma will not reduce failure rates. After an initial time period, reservoir function will not change over time.

scholarly journals Early and late side effects, dosimetric parameters and quality of life after proton beam therapy and IMRT for prostate cancer: a matched-pair analysis

2019 ◽  
Vol 58 (6) ◽  
pp. 916-925 ◽  
Author(s):  
Almut Dutz ◽  
Linda Agolli ◽  
Michael Baumann ◽  
Esther G. C. Troost ◽  
Mechthild Krause ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Side Effects ◽  
Proton Beam ◽  
Proton Beam Therapy ◽  
Matched Pair ◽  
Matched Pair Analysis ◽  
Pair Analysis ◽  
Late Side

scholarly journals Long-Term Followup of Patients with Active J-Reservoirs after Restorative Proctocolectomy for Ulcerative Colitis with regard to Reservoir Function, Mucosal Changes, and Quality of Life

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Ola Røkke ◽  
Knut Iversen ◽  
Torill Olsen ◽  
Sølvi-May Ristesund ◽  
Geir Egil Eide ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ulcerative Colitis ◽  
Restorative Proctocolectomy ◽  
High Frequency ◽  
Functional Results ◽  
Favourable Result ◽  
Life Questionnaire ◽  
Calprotectin Level ◽  
Mucosal Changes

Objective. Study the functional results and mucosal changes in the ileal pouch after restorative proctocolectomy with J-reservoir for ulcerative colitis. Material and Methods. Followup study of 125 patients with J-reservoir with one disease-specific- and one general (SF-36) quality of life-questionnaire, rectoscopy with biopsies, and stool samples to evaluate inflammation, dysplasia, presence of Helicobacter pylori and calprotectin level. Results. Fourteen J-reservoirs were removed or deactivated, leaving 111 patients for followup. The followup time was 6.8 (1–15) years. 87.4% of the patients were satisfied. 93.1% had some kind of functional restriction: food- (75.5%), social- (28.9%), physical- (37%) or sexual restriction (15.3%). 18.6% had often or sometimes faecal incontinence. Low daytime faecal frequency was associated with good quality of life. 13 patients (12.6%) had a less favourable result. There was no pouch-dysplasia. Calprotectin levels were increased in patients with visible pouch inflammation or history of pouchitis. HP was diagnosed by RUT in 42.3%, but was not associated with inflammation or pouchitis. Conclusions. Most patients were satisfied with the J-reservoir in spite of a high frequency of various restrictions. 12.6% (13 patients) had a less favourable functional result, partly due to a high frequency of defecations, pain, pouchitis and inflammation.

Complications and quality of life after ileorectal anastomosis for ulcerative colitis

1985 ◽  
Vol 149 (1) ◽  
pp. 23-30 ◽  
Author(s):  
John R. Oakley ◽  
David G. Jagelman ◽  
Victor W. Fazio ◽  
Ian C. Lavery ◽  
Frank L. Weakley ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ulcerative Colitis ◽  
Ileorectal Anastomosis
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