Colorectal Unit, Department of Digestive Surgery, Pontificia Universidad Católica de Chile, Diagonal Paraguay, 362, Santiago, Región Metropolitana, Chile.
Int J Colorectal Dis. 2020 Apr;35(4):747-753. doi: 10.1007/s00384-020-03529-7. Epub 2020 Feb 18.
Ileal pouch-anal anastomosis (IPAA) has become the surgical procedure of choice for patients with ulcerative colitis (UC). IPAA was incorporated into our institution in 1984, and thereafter, more than 200 procedures have been performed. The functional results and morbidity of this surgery have been reported previously. However, long-term functional outcomes and quality of life have not been evaluated.
As a cohort study, we identified all consecutive patients who underwent IPAA for UC between 1984 and 2017 and selected those with more than 10-year follow-up. Demographic data, morbidity, and pouch survival information were obtained. Long-term functional results and quality of life were evaluated through an e-mail survey using the Öresland score and the Cleveland Global Quality of Life scales, respectively.
Of 201 patients, 116 met the inclusion criteria. Median follow-up was 20 (10-34) years. Early post-operative complications (30 days) were observed in 19 (16.4%) patients and 66 (56.9%) presented adverse events. The IPAA preservation rate at 10 and 20 years was 96.5% and 93.1%, respectively. Long-term functional scores presented a median of 6 (1-15) points. IPAA function was satisfactory in 11 (20.0%) patients, acceptable in 18 (32.7%), and deficient in 26 (47.3%). The median score for global quality of life was 0.8 (0.23-1.0) points.
IPAA as treatment for UC meets the expectations of cure of the disease, maintaining adequate long-term intestinal functionality associated with a good quality of life in most patients.
回肠贮袋肛管吻合术（IPAA）已成为溃疡性结肠炎（UC）患者的首选手术方法。我们医院于 1984 年开始采用这种手术，此后已进行了 200 多例手术。该手术的功能结果和发病率已在之前报道过。然而，长期的功能结果和生活质量尚未得到评估。
作为一项队列研究，我们确定了 1984 年至 2017 年间接受 IPAA 治疗 UC 的所有连续患者，并选择了随访时间超过 10 年的患者。我们获取了人口统计学数据、发病率和贮袋存活率信息。通过电子邮件调查，使用Öresland 评分和克利夫兰全球生活质量量表分别评估长期功能结果和生活质量。
在 201 名患者中，有 116 名符合纳入标准。中位随访时间为 20 年（10-34 年）。19 名（16.4%）患者在术后 30 天内出现早期术后并发症，66 名（56.9%）患者出现不良事件。10 年和 20 年时的 IPAA 存活率分别为 96.5%和 93.1%。长期功能评分中位数为 6 分（1-15 分）。11 名（20.0%）患者的 IPAA 功能满意，18 名（32.7%）患者可接受，26 名（47.3%）患者功能不足。全球生活质量中位数评分为 0.8 分（0.23-1.0 分）。
作为 UC 的治疗方法，IPAA 满足了治愈疾病的期望，在大多数患者中保持了足够的长期肠道功能，并伴有良好的生活质量。
