Functional Outcome and Quality of Life After Restorative Proctocolectomy and Ileal Pouch-Anal Anastomosis in Elderly Patients

Abstract

SUMMARY Restorative proctocolectomy with ileal pouch-anal anastomosis is the surgical treatment of choice for patients with medically refractory ulcerative colitis, ulcerative colitis with dysplasia or cancer, or familial adenomatous polyposis (FAP), regardless of their age. The aim of the paper was to report our 6-year experience of restorative proctocolectomy and ileal pouch-anal anastomosis in elderly population at the tertiary referral centre. Chart review was performed for four patients undergoing ileal pouch-anal anastomosis from 2006 to 2010. Preoperative histopathologic diagnosis was ulcerative colitis. We collected data regarding patients’ demographics, type and duration of disease, previous operations and indications for surgery. We analyzed the operative protocols and postoperative pathologic diagnosis. Early (within 30 days after surgery) and late complications were noted. Follow-up was conducted upon annual function and quality of life questionnaire, physical examination and endoscopic evaluation of the pouch. Postoperative histopathologic diagnoses were: ulcerative colitis (n=2) and indeterminate colitis (n=2). The average age of the operated patients was 59 years. The mean duration of the follow-up was four years. We report two cases of steroid use prior to operation as well as two cases of extraintestinal manifestations. We report no septic complications and two cases of pouchitis. Functional results and quality of life were good to excellent in all four cases of ileal pouch-anal anastomosis. Restorative proctocolectomy with ileal pouch-anal anastomosis in elderly people is a safe procedure with low morbidity rate. Functional results are generally good and patient satisfaction is high.