Quality of life ten and more years after restorative proctocolectomy for patients with familial adenomatous polyposis coli

PURPOSE: - Few studies on long-term quality of life after restorative proctocolectomy and ileal pouch-anal anastomosis have been published. Most of them survey a mixed patient population of familial adenomatous polyposis and ulcerative colitis. The present study analyzes long-term results...

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Main Authors: Ganschow, Petra (Author) , Pfeiffer, Ulrike (Author) , Hinz, Ulf (Author) , Leowardi-Bauer, Christine (Author) , Herfarth, Christian (Author) , Kadmon, Martina (Author)
Format: Article (Journal)
Language:English
Published: October 2010
In: Diseases of the colon & rectum
Year: 2010, Volume: 53, Issue: 10, Pages: 1381-1387
ISSN:1530-0358
DOI:10.1007/DCR.0b013e3181e56feb
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1007/DCR.0b013e3181e56feb
Verlag, lizenzpflichtig, Volltext: https://journals.lww.com/dcrjournal/fulltext/2010/10000/quality_of_life_ten_and_more_years_after.6.aspx
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Author Notes:Petra Ganschow, Ulrike Pfeiffer, Ulf Hinz, Christine Leowardi, Christian Herfarth, Martina Kadmon

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520 |a PURPOSE: - Few studies on long-term quality of life after restorative proctocolectomy and ileal pouch-anal anastomosis have been published. Most of them survey a mixed patient population of familial adenomatous polyposis and ulcerative colitis. The present study analyzes long-term results more than 10 years after ileal pouch-anal anastomosis for patients with familial adenomatous polyposis, exclusively. - METHODS: - One hundred thirty-five patients who underwent ileal pouch-anal anastomosis more than 10 years ago were identified from the prospective familial adenomatous polyposis registry at Heidelberg University hospital. They received the German version of the health-specific Short Form 36 Health Survey and the disease-specific Gastrointestinal Quality of Life Index by mail. To assess the impact of disease-specific factors, 10 questions asking for ability to work, current medication, pouchitis, and extracolonic manifestations of familial adenomatous polyposis were added to the Gastrointestinal Quality of Life Index questionnaire. - RESULTS: - Among 84 patients who answered the questionnaires the median follow-up was 13.4 years (range, 10.3-23.8 y).The results of the Short Form 36 Health Survey were comparable to a German normative population in all dimensions, whereas the overall score for the Gastrointestinal Quality of Life Index was significantly reduced compared with healthy individuals (111.8 vs 120.8, P = .0014). Carcinoma at the time of ileal pouch-anal anastomosis, desmoid tumors, or duodenal adenomas had no significant influence on quality of life. More than 7 bowel movements during the daytime were found to reduce quality of life significantly (103.5 vs 115, P = .0127). More than 2 defecations per night diminished the score further (101 vs 125, P < .0001). Patients younger than 40 years at the time of ileal pouch-anal anastomosis had significantly better results than older patients (120 vs 109.5, P = .0076). - CONCLUSION: - Ileal pouch-anal anastomosis is a safe surgical procedure with a high quality of life comparable to that of a normative population after long-term follow-up of patients with familial adenomatous polyposis. 
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