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01-03-2019 | Original Article

Factors Associated with Long-Term Quality of Life After Restorative Proctocolectomy with Ileal Pouch Anal Anastomosis

Authors: Olga A. Lavryk, Luca Stocchi, Tracy L. Hull, Emre Gorgun, Sherief Shawki, Jeremy M. Lipman, Stefan D. Holubar, Conor P. Delaney, Scott R. Steele

Published in: Journal of Gastrointestinal Surgery | Issue 3/2019

Abstract

The aim

The aim of this study was to analyze factors associated with quality of life (QoL) after ileal pouch anal anastomosis (IPAA).

Methods

Patients who underwent IPAA (1983–2015) and replied to QoL questionnaire were identified from an IRB-approved prospectively maintained IPAA-database. QoL was assessed using Cleveland Global Quality of Life (CGQL) questionnaire at 1, 3, 5, and 10 years postoperatively. Patient cohort was divided in two groups: overall QoL score ≤ 0.7 (low) and > 0.7 (high). Demographics, perioperative morbidity, and functional results were analyzed.

Results

A total of 4059 patients replied to the questionnaire at the most recent follow-up and were included. A total of 2889 (71%) had overall QoL > 0.7 (group 1) and 1170 (29%) patients had overall QoL ≤ 0.7 (group 2). Patients in group 1 had lower rates of early (44.6 vs. 50.4%, p = 0.003) and late (55.7 vs. 64.5%, p < 0.003) postoperative complications. Kaplan-Meier survival analysis demonstrated significantly higher rates of pouch failure among patients with lower QoL. Pouchitis, obstruction, fistulas, higher number of stools, and IPAA performed during the most recent decade (2005–2015) were significantly associated with lower QoL (≤ 0.7), while S-pouch configuration was associated with higher QoL (> 0.7).

Conclusion

Patient’s characteristics and minimal perioperative complications impact patient’s QoL following IPAA not only in the short term, but also in the long term.

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Title: Factors Associated with Long-Term Quality of Life After Restorative Proctocolectomy with Ileal Pouch Anal Anastomosis
Authors: Olga A. Lavryk
Luca Stocchi
Tracy L. Hull
Emre Gorgun
Sherief Shawki
Jeremy M. Lipman
Stefan D. Holubar
Conor P. Delaney
Scott R. Steele
Publication date: 01-03-2019
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 3/2019
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-018-3904-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Factors Associated with Long-Term Quality of Life After Restorative Proctocolectomy with Ileal Pouch Anal Anastomosis

Abstract

The aim

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

The aim

Methods

Results

Conclusion

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