Ileoanal Pouch Versus Ileostomy: Is There a Difference in Quality of Life?

Seidel, Scott A.; Newman, Martin; Sharp, Kenneth W.
June 2000
American Surgeon;Jun2000, Vol. 66 Issue 6, p540
Academic Journal
Ileoanal pouch (IAP) construction is arguably the procedure of choice to follow proctocolectomy for ulcerative colitis (UC) or familial adenomatous polyposis (FAP). Patients with UC or FAP at our institution choose their operation after counseling with the surgeon, with an enterostomal therapist, and with patients who have undergone IAP and proctocolectomy with ileostomy (IL). We studied these patients who chose IAP and IL, to determine differences in outcome and quality of life (QOL) between those two groups. We assessed outcomes by evaluating clinic and hospital records and surveyed patients' QOL via a standardized questionnaire. During a retrospective 10-year study period, 86 patients underwent evaluation for IAP construction for UC (64) and FAP (22). Fifty-five patients underwent IAP construction, and 31 underwent IL. There were no operative deaths. Thirty-four patients sustained 69 early and late complications (40%). The IAP group experienced a higher complication rate, 53 per cent, compared with the IL group, 16 per cent. Forty-five patients (56%) have completed questionnaires. Eighty-seven per cent of IAP patients and 93 per cent of IL patients responded that their overall QOL is "always" better since their operation (P = not significant). Both groups reported very favorable responses to questions regarding work, social life, family life, sleep, and relationships without statistically significant differences between the two groups. Despite a high complication rate, IAP is an excellent operation for many patients with UC or FAP, but patients who choose IL after preoperative counseling can be expected to have similar improvement in quality of life.


Related Articles

  • The new trend in ileostomy surgery. Cassell, Belva L. // RN;Jan84, Vol. 47 Issue 1, p48 

    Introduces Kock pouch surgery for ileostomy patients. Description of the pouch; Method of creating the pouch; Postoperatively nursing care after Kock pouch surgery; Draining the pouch. INSET: The surgical formation of a Kock pouch.

  • A new modern drainable appliance for people with ileostomies. Davenport, Rebecca; Sica, Jom // British Journal of Nursing;5/8/2003, Vol. 12 Issue 9, p571 

    Features the one-piece drainable pouch for ileostomy patients developed by Welland Medical. Dual-Carb filter incorporated in the product which combines modified and unmodified carbon to help fight the various odor types that an ileostomy can produce.

  • Adenocarcinoma After Ileoanal Anastomosis for Familial Adenomatous Polyposis: Review of Risk Factors and Current Surveillance Apropos of A Case Campos, Fábio Guilherme; Habr-Gama, Angelita; Kiss, Desidério Roberto; da Silva, Edésio Vieira; Rawet, Viviane; Imperiale, Antônio Rocco; Perez, Rodrigo; da Silva, José Hyppólito; Sousa, Afonso Henrique S.; Gama-Rodrigues, Joaquim; Campos, Fábio Guilherme; Kiss, Desidério Roberto; da Silva, Edésio Vieira; Imperiale, Antônio Rocco; da Silva, José Hyppólito; Sousa, Afonso Henrique S Jr // Journal of Gastrointestinal Surgery;May2005, Vol. 9 Issue 5, p695 

    Restorative proctocolectomy has become the most common surgical option for familial adenomatous polyposis (FAP) patients, based on the premise that it provides good functional results and reduces colorectal cancer risk. But several adenomas may develop in the pouch mucosa over the years, and...

  • Effect of high-dose steroids on anastomotic complications after proctocolectomy with ileal pouch–anal anastomosis Lake, Jeffrey P.; Firoozmand, Eiman; Kang, Jung-Cheng; Vassiliu, Panteleimon; Chan, Linda S.; Vukasin, Petar; Kaiser, Andreas M.; Beart Jr., Robert W.; Beart, Robert W Jr // Journal of Gastrointestinal Surgery;Jul2004, Vol. 8 Issue 5, p547 

    This review was designed to determine whether “high-dose” steroid therapy (⩾20 mg prednisone/day) increases the likelihood of anastomotic complications after restorative proctocolectomy with ileal pouch–anal anastomosis (IPAA). The hospital records of 100 patients...

  • Pouchitis. Schouten, W. R. // Mediators of Inflammation;Jun98, Vol. 7 Issue 3, p175 

    POUCHITIS is a major long-term complication of the continent ileostomy as well as the ileoanal pouch anastomosis. When diagnosed on the basis of clinical, endoscopic and histologic features, this syndrome has been demonstrated almost exclusively in patients with ulcerative colitis. The clinical...

  • Restorative proctocolectomy for collagenous colitis. Riaz, A. A.; Pitt, J.; Stirling, R. W.; Madaan, S.; Dawson, P. M. // Journal of the Royal Society of Medicine;May2000, Vol. 93 Issue 5, p261 

    The article describes the case of a 59-year-old woman who has a three-month history of frequent watery diarrhea and mild abdominal discomfort. She was diagnosed with collagenous colitis after examining biopsies taken at colonoscopy. After two years, she underwent a restorative proctocolectomy...

  • Anatomical basis for the interposition of a gastric pouch between the ileum and the anus after total proctocolectomy. Cheynel, N.; Rat, P.; Diane, B.; Peschaud, F.; Trouilloud, P.; Favre, J.-P. // Surgical & Radiologic Anatomy;May2003, Vol. 25 Issue 2, p95 

    After a total proctocolectomy, ileoanal continuity is achieved by an ileal pouch–anal anastomosis. This anastomosis is not possible when the ileum cannot reach the anus. To avoid definitive ileostomy in this circumstance, we devised a gastric pouch, taken from the left half of the...

  • Invited comment on Selvaggi et al.: Is omitting pouchography before ileostomy takedown safe after negative clinical examination in asymptomatic patients with pelvic ileal pouch? An observational study. Kelley, S.; Dozois, E. // Techniques in Coloproctology;Dec2012, Vol. 16 Issue 6, p421 

    The article offers the authors' insights on the article "Is omitting pouchography before ileostomy takedown safe after negative clinical examination in asymptomatic patients with pelvic ileal pouch? An observational study," by Selvaggi and colleagues. They say that the authors have provided some...

  • Is omitting pouchography before ileostomy takedown safe after negative clinical examination in asymptomatic patients with pelvic ileal pouch? An observational study. Selvaggi, F.; Pellino, G.; Canonico, S.; Sciaudone, G. // Techniques in Coloproctology;Dec2012, Vol. 16 Issue 6, p415 

    Background: When restorative proctocolectomy (RPC) is performed, a temporary diverting loop ileostomy is often fashioned and usually closed 2-3 months later. Pouchography is used to assess pouch integrity, although its benefits have been questioned and no definitive data support its routine use....


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics