Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
Langenbecks Arch Surg. 2010 Jan;395(1):49-56. doi: 10.1007/s00423-009-0479-7. Epub 2009 Mar 12.
The aim of this study was to assess quality of life (QOL) in a long-term follow-up of patients with ulcerative colitis (UC) 10 years and more after ileal pouch-anal anastomosis (IPAA) to correlate these results with pouch function and to assess the long-term pouch failure rate.
In a unicentric study, 294 consecutive patients after IPAA between 1988 and 1996 were identified from a prospective database. QOL was evaluated according to the validated Gastrointestinal Quality of Life Index (GIQLI).
Overall median follow-up was 11.5 years. Thirty-seven patients experienced pouch failure (12.6%). The rates of ileal pouch success after 5, 10 and 15 years were 92.3%, 88.7% and 84.5%. According to the GIQLI, patients with a functioning pouch achieved a mean score of 107.8, reflecting a decrease of QOL of 10.8% compared to a healthy population. There were significant negative correlations between QOL and an age of >50 years (p < 0.05), pouchitis, perianal inflammation and increased stool frequency (p < 0.0001).
QOL and functional results of patients with UC 10 years or more after IPAA were acceptable; however, those were reduced when compared to a healthy population. Pouch failure rate still increases up to 15.5% 15 years after IPAA. This result represents an important issue in providing patients with comprehensive preoperative information.
本研究旨在评估溃疡性结肠炎（UC）患者行回肠贮袋肛管吻合术（IPAA）后 10 年及以上的生活质量（QOL），并将这些结果与贮袋功能相关联，同时评估长期贮袋失败率。
在单中心研究中，从 1988 年至 1996 年前瞻性数据库中确定了 294 例接受 IPAA 的连续患者。采用经验证的胃肠道生活质量指数（GIQLI）评估 QOL。
总体中位随访时间为 11.5 年。37 例患者发生贮袋失败（12.6%）。5、10 和 15 年后回肠贮袋成功的比率分别为 92.3%、88.7%和 84.5%。根据 GIQLI，功能正常的贮袋患者的平均得分为 107.8，反映出 QOL 较健康人群下降了 10.8%。QOL 与年龄>50 岁（p<0.05）、贮袋炎、肛周炎症和粪便频率增加呈显著负相关（p<0.0001）。
UC 患者在接受 IPAA 10 年或更长时间后，其 QOL 和功能结果是可以接受的；然而，与健康人群相比，这些结果仍有所降低。IPAA 后 15 年，贮袋失败率仍在增加，达到 15.5%。这一结果在为患者提供全面的术前信息方面是一个重要的问题。
