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Impact of sex on 30-day complications and long-term functional outcomes following ileal pouch-anal anastomosis for chronic ulcerative colitis

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

To determine the impact of patient sex on operative characteristics, short-term complications, and long-term functional outcomes following ileal pouch-anal anastomosis (IPAA) for chronic ulcerative colitis (CUC).

Methods

A retrospective review was performed on all patients undergoing two- or three-stage IPAA for CUC at our institution between January 2002 and August 2013. Patient demographics, operative characteristics, 30-day postoperative complications, and long-term functional outcomes from annual survey data were analyzed comparing men and women patients.

Results

During the study period, 911 IPAAs (542 men, 369 women) were performed. Men were older and were more often obese (both p < 0.01). Use of a three-stage approach and laparoscopic approach were similar between men and women, but operation length, intraoperative blood loss, and hospital length of stay were all higher in men (all p < 0.05). At 30 days, women had increased rates of superficial surgical site infections and urinary tract infections (both p < 0.05), while men had increased rates of urinary retention (p = 0.03). Five hundred forty-six patients (60%; 307 men, 239 women) responded to the annual post IPAA survey with a median follow-up of 5.1 and 5.0 years in men and women, respectively. Women reported increased frequency of daytime stools in the early follow-up period, but this difference resolved with time. Other functional outcomes were similar.

Conclusion

Patient sex impacts intraoperative complexity, postoperative length of stay, 30-day postoperative outcomes, and initial long-term function. These findings underscore the need to adjust preoperative counseling regarding IPAA outcomes based on sex.

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Authors and Affiliations

  1. Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN, USA

    Nicholas P. McKenna, Eric J. Dozois, John H. Pemberton & Amy L. Lightner

  2. Department of Surgery, Division of Colon and Rectal Surgery, Mayo Clinic College of Medicine, 200 1st St SW, Rochester, MN, 55902, USA

    Amy L. Lightner

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  1. Nicholas P. McKenna
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  2. Eric J. Dozois
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  4. Amy L. Lightner
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Correspondence to Amy L. Lightner.

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Meeting presentation

A portion of this work was presented as a podium presentation at the Scientific Forum at the 2017 American College of Surgeons Clinical Congress in San Diego, CA in October 2017.

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McKenna, N.P., Dozois, E.J., Pemberton, J.H. et al. Impact of sex on 30-day complications and long-term functional outcomes following ileal pouch-anal anastomosis for chronic ulcerative colitis. Int J Colorectal Dis 33, 619–625 (2018). https://doi.org/10.1007/s00384-018-3020-z

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