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Transanal ileal pouch-anal anastomosis for ulcerative colitis has comparable long-term functional outcomes to transabdominal approach: a multicentre comparative study

Chandrasinghe, Pramodh ; Carvello, Michele ; Wasmann, Karin ; Foppa, Caterina ; Tanis, Pieter ; Perry-Woodford, Zarah ; Warusavitarne, Janindra ; Spinelli, Antonino ; Bemelman, Willem

Journal of Crohn's & colitis, 22 October 2019 [Rivista Peer Reviewed]

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  • Titolo:
    Transanal ileal pouch-anal anastomosis for ulcerative colitis has comparable long-term functional outcomes to transabdominal approach: a multicentre comparative study
  • Autore: Chandrasinghe, Pramodh ; Carvello, Michele ; Wasmann, Karin ; Foppa, Caterina ; Tanis, Pieter ; Perry-Woodford, Zarah ; Warusavitarne, Janindra ; Spinelli, Antonino ; Bemelman, Willem
  • Note di contenuto: The transanal approach to ileal pouch-anal anastomosis (Ta-IPAA) provides better access to the lower pelvis with lower short-term morbidity in ulcerative colitis (UC). The aim of this study was to assess the long-term functional outcomes after Ta-IPAA versus transabdominal IPAA (Abd-IPAA) in UC. A multicentre cohort analysis was done between March 2002 and September 2017. Patient characteristics, surgical details and postoperative outcomes were compared. CGQL (Cleveland global quality of life) score at 12 months with a functioning pouch was considered the primary endpoint. A total of 374 patients (100 Ta-IPAA vs 274 Abd-IPAA) were included. Ta-IPAA demonstrated a comparable overall quality of life (CGQL score) to Abd-IPAA (0.75 ± 0.11 vs 0.71 ± 0.14; respectively, p=0.1). Quality of life (7.71 ± 1.17 vs 7.30 ± 1.46; p=0.04) and energy level items (7.16 ± 1.52 vs 6.66 ± 1.68; p=0.03) were significantly better after Ta-IPAA, while the quality of health item was comparable (7.68 ± 1.26 vs 7.64 ± 1.44; p=0.96). Analysis excluding anastomotic leaks did not change the overall CGQL scores. Stool frequencies (>10/ 24 hrs:22% vs 21%; p=1.0) and the rate of single episode of major incontinence during the 12-month period (27% vs 26%; p=0.89) were similar. The differences in thirty-day morbidity rates (33% vs 41%; p=0.2) and the anastomotic leak rates were not significant (6% vs 13%; p=0.09). This study provides evidence of comparable long-term functional outcome and quality of life after Ta-IPAA and Abd-IPAA for UC.
  • Fa parte di: Journal of Crohn's & colitis, 22 October 2019
  • Soggetti: Pouch Anal Anastomosis ; Transanal Surgery ; Ulcerative Colitis
  • Lingua: Inglese
  • Tipo: Articolo
  • Identificativo: E-ISSN: 1876-4479 ; PMID: 31637417 Version:1 ; DOI: 10.1093/ecco-jcc/jjz174
  • Fonte: MEDLINE/PubMed (U.S. National Library of Medicine)

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