Department of Colorectal Surgery, Beaumont Hospital, Dublin 9, Ireland.
Department of Surgery, Royal College of Surgeons in Ireland, Dublin 2, Ireland.
Ir J Med Sci. 2021 Feb;190(1):275-280. doi: 10.1007/s11845-020-02297-1. Epub 2020 Jul 8.
An ileal pouch anal anastomosis (IPAA) is the treatment of choice in selected patients to restore intestinal continuity following proctocolectomy. Data on IPAA in the Republic of Ireland is lacking, and surgery for IPAA has evolved over time. The aim of this retrospective study was to report our institutional outcomes from IPAA over a 20-year period.
Data were retrospectively collated from consecutive primary IPAA cases between 1998 and 2017 at Beaumont Hospital. Patient demographics and operative approach were examined, and pouch failure was estimated using the Kaplan-Meier method.
Ninety-five patients underwent IPAA over the study period with a mean follow-up of 9.4 ± 5.6 years. The mean age at IPAA was 35.9 ± 10.0 years, and 58.9% were male. The majority were performed in 3 stages (78.9%), were performed to treat ulcerative colitis (66.3%), were of a J-pouch configuration (96.8%), and had a stapled anastomosis (70.5%). On follow-up, 28.4% reported experiencing at least 1 episode of pouchitis and the 10-year pouch failure rate was 14%. In the last decile of the study period, the mean number of IPAA performed per year increased to 10.5 ± 2.1 (P = 0.013), the age of IPAA formation reduced (P = 0.049), and the proportion completed in a minimally invasive manner increased (P < 0.001).
Acceptable long-term outcomes were observed by our institution. A recent increase in institutional volume, reduction in patient age, and increase in the proportion of cases performed laparoscopically have been identified.
回肠贮袋肛管吻合术（IPAA）是在某些患者中选择重建直肠连续性的治疗方法。爱尔兰共和国缺乏有关 IPAA 的数据，并且 IPAA 的手术技术也随着时间的推移而发展。本回顾性研究的目的是报告我们机构在 20 年期间进行 IPAA 的结果。
我们回顾性地收集了 1998 年至 2017 年期间在 Beaumont 医院进行的连续原发性 IPAA 病例的数据。检查了患者的人口统计学和手术方法，并使用 Kaplan-Meier 方法估计了贮袋失败率。
在研究期间，95 例患者接受了 IPAA 治疗，平均随访时间为 9.4±5.6 年。IPAA 的平均年龄为 35.9±10.0 岁，58.9%为男性。大多数患者接受了 3 期手术（78.9%），用于治疗溃疡性结肠炎（66.3%），为 J 袋型（96.8%），吻合口为吻合器吻合（70.5%）。在随访期间，28.4%的患者报告至少发生过 1 次贮袋炎，10 年贮袋失败率为 14%。在研究期间的最后 10 年，每年进行的 IPAA 例数平均增加到 10.5±2.1（P=0.013），IPAA 形成的年龄降低（P=0.049），并且微创方式完成的比例增加（P<0.001）。
我们机构观察到了可接受的长期结果。机构数量的增加，患者年龄的降低以及腹腔镜手术比例的增加。
