Skip to main content
SpringerLink
Log in

Which Ulcerative Colitis Patients Should Not Have Ileal Pouch-Anal Anastomosis

  • Chapter
  • First Online:
Difficult Decisions in Colorectal Surgery

Part of the book series: Difficult Decisions in Surgery: An Evidence-Based Approach ((DDSURGERY))

Abstract

Only a minority of patients afflicted with ulcerative will require operative management of their disease. Several operative options can be considered for this selected group, but proctocolectomy with ileal pouch-anal anastomosis has evolved to supplant proctocolectomy with end ileostomy as the procedure of choice for most patients. However, careful review of the literature suggests that the two procedures are associated with comparable long-term outcomes as measured by health-related quality of life. Accordingly, several patient-specific variables (e.g., body mass index, presence of associated or co-morbid conditions, sphincter function) must be considered before recommending the procedure that best suits the individual patient.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Kornbluth A, Sachar DB. Ulcerative colitis practice guidelines in adults: American College of Gastroenterology, Practice Parameters Committee. Am J Gastroenterol. 2010;105:501–23.

    Article  PubMed  Google Scholar 

  2. Dignass A, Lindsay JO, Sturm A, Windsor A, Colombel JF, Allez M, D’Haens G, D’Hoore A, Mantzaris G, Novacek G, Oresland T, Reinisch W, Sans M, Stange E, Vermeire S, Travis S, Van Assche G. Second European evidence-based consensus on the diagnosis and management of ulcerative colitis part 2: current management. J Crohns Colitis. 2012;6:991–1030.

    Article  PubMed  Google Scholar 

  3. Ross H, Steele SR, Varma M, Dykes S, Cima R, Buie WD, Rafferty J, Standards Practice Task Force of the American Society of Colon and Rectal Surgeons. Practice parameters for the surgical treatment of ulcerative colitis. Dis Colon Rectum. 2014;57:5–22.

    Article  PubMed  Google Scholar 

  4. Øresland T, Bemelman WA, Sampietro GM, Spinelli A, Windsor A, Ferrante M, Marteau P, Zmora O, Kotze PG, Espin-Basany E, Tiret E, Sica G, Panis Y, Faerden AE, Biancone L, Angriman I, Serclova Z, de Buck van Overstraeten A, Gionchetti P, Stassen L, Warusavitarne J, Adamina M, Dignass A, Eliakim R, Magro F, D’Hoore A, European Crohn’s Colitis Organisation (ECCO). European evidence based consensus on surgery for ulcerative colitis. J Crohns Colitis. 2015;9:4–25.

    PubMed  Google Scholar 

  5. Emblem R, Larsen S, Torvet SH, Bergan A. Operative treatment of ulcerative colitis: conventional proctectomy with Brooke ileostomy versus mucosal proctectomy with ileoanal anastomosis. Scand J Gastroenterol. 1988;23:493–500.

    Article  CAS  PubMed  Google Scholar 

  6. McLeod RS, Churchill DN, Lock AM, Vanderburgh S, Cohen Z. Quality of life of patients with ulcerative colitis preoperatively and postoperatively. Gastroenterology. 1991;101:1307–13.

    Article  CAS  PubMed  Google Scholar 

  7. Liddell A, Pollett WG, MacKenzie DS. Comparison of postoperative satisfaction between ulcerative colitis patients who chose to undergo either a pouch or an ileostomy operation. Int J Rehabil Heal. 1995;1:89–96.

    Article  Google Scholar 

  8. O’Bichere A, Wilkinson K, Rumbles S, Norton C, Green C, Phillips RK. Functional outcome after restorative panproctocolectomy for ulcerative colitis decreases an otherwise enhanced quality of life. Br J Surg. 2000;87:802–7.

    Article  PubMed  Google Scholar 

  9. Nordin K, Påhlman L, Larsson K, Sundberg-Hjelm M, Lööf L. Health-related quality of life and psychological distress in a population-based sample of Swedish patients with inflammatory bowel disease. Scand J Gastroenterol. 2002;37:450–7.

    Article  CAS  PubMed  Google Scholar 

  10. Camilleri-Brennan J, Munro A, Steele RJ. Does an ileoanal pouch offer a better quality of life than a permanent ileostomy for patients with ulcerative colitis? J Gastrointest Surg. 2003;7:814–9.

    Article  PubMed  Google Scholar 

  11. Kuruvilla K, Osler T, Hyman NH. A comparison of the quality of life of ulcerative colitis patients after IPAA vs ileostomy. Dis Colon Rectum. 2012;55:1131–7.

    Article  PubMed  Google Scholar 

  12. van der Valk ME, Mangen MJ, Severs M, van der Have M, Dijkstra G, van Bodegraven AA, Fidder HH, de Jong DJ, Pierik M, van der Woude CJ, Romberg-Camps MJ, Clemens CH, Jansen JM, van de Meeberg PC, Mahmmod N, van der Meulen-de Jong AE, Ponsioen CY, Bolwerk C, Vermeijden JR, Siersema PD, Leenders M, Oldenburg B, COIN study group, Dutch Initiative on Crohn and Colitis. Comparison of costs and quality of life in ulcerative colitis patients with an ileal pouch-anal anastomosis, ileostomy and anti-TNF therapy. J Crohns Colitis. 2015;9:1016–23.

    Article  PubMed  Google Scholar 

  13. Wu XR, Kiran RP, Remzi FH, Katz S, Mukewar S, Shen B. Preoperative pelvic radiation increases the risk for ileal pouch failure in patients with colitis-associated colorectal cancer. J Crohns Colitis. 2013;7:e419–26.

    Article  PubMed  Google Scholar 

  14. Wertzberger BE, Sherman SK, Byrn JC. Differences in short-term outcomes among patients undergoing IPAA with or without preoperative radiation: a National Surgical Quality Improvement Program analysis. Dis Colon Rectum. 2014;57:1188–94.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Radice E, Nelson H, Devine RM, Dozois RR, Nivatvongs S, Pemberton JH, Wolff BG, Fozard BJ, Ilstrup D. Ileal pouch-anal anastomosis in patients with colorectal cancer: long-term functional and oncologic outcomes. Dis Colon Rectum. 1998;41:11–7.

    Article  CAS  PubMed  Google Scholar 

  16. Kiran RP, Remzi FH, Fazio VW, Lavery IC, Church JM, Strong SA, Hull TL. Complications and functional results after ileoanal pouch formation in obese patients. J Gastrointest Surg. 2008;12:668–74.

    Article  CAS  PubMed  Google Scholar 

  17. Canedo JA, Pinto RA, McLemore EC, Rosen L, Wexner SD. Restorative proctectomy with ileal pouch-anal anastomosis in obese patients. Dis Colon Rectum. 2010;53:1030–4.

    Article  PubMed  Google Scholar 

  18. Klos CL, Safar B, Jamal N, Hunt SR, Wise PE, Birnbaum EH, Fleshman JW, Mutch MG, Dharmarajan S. Obesity increases risk for pouch-related complications following restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA). J Gastrointest Surg. 2014;18:573–9.

    Article  PubMed  Google Scholar 

  19. de Zeeuw S, Ahmed Ali U, Donders RA, Hueting WE, Keus F, van Laarhoven CJ. Update of complications and functional outcome of the ileo-pouch anal anastomosis: overview of evidence and meta-analysis of 96 observational studies. Int J Colorectal Dis. 2012;27:843–53.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Fazio VW, Kiran RP, Remzi FH, Coffey JC, Heneghan HM, Kirat HT, Manilich E, Shen B, Martin ST. Ileal pouch anal anastomosis: analysis of outcome and quality of life in 3707 patients. Ann Surg. 2013;257:679–85.

    Article  PubMed  Google Scholar 

  21. Lian L, Menon KV, Shen B, Remzi F, Kiran RP. Inflammatory bowel disease complicated by primary sclerosing cholangitis and cirrhosis: is restorative proctocolectomy safe? Dis Colon Rectum. 2012;55:79–84.

    Article  PubMed  Google Scholar 

  22. Pavlides M, Cleland J, Rahman M, Christian A, Doyle J, Gaunt R, Travis S, Mortensen N, Chapman R. Outcomes after ileal pouch anal anastomosis in patients with primary sclerosing cholangitis. J Crohns Colitis. 2014;8:662–70.

    Article  PubMed  Google Scholar 

  23. Cho CS, Dayton MT, Thompson JS, Koltun WA, Heise CP, Harms BA. Proctocolectomy-ileal pouch-anal anastomosis for ulcerative colitis after liver transplantation for primary sclerosing cholangitis: a multi-institutional analysis. J Gastrointest Surg. 2008;12:1221–6.

    Article  PubMed  Google Scholar 

  24. Halverson AL, Hull TL, Remzi F, Hammel JP, Schroeder T, Fazio VW. Perioperative resting pressure predicts long-term postoperative function after ileal pouch-anal anastomosis. J Gastrointest Surg. 2002;6:316–20.

    Article  PubMed  Google Scholar 

  25. Gearhart SL, Hull TL, Schroeder T, Church J, Floruta C. Sphincter defects are not associated with long-term incontinence following ileal pouch-anal anastomosis. Dis Colon Rectum. 2005;48:1410–5.

    Article  PubMed  Google Scholar 

  26. Scoglio D, Ahmed Ali U, Fichera A. Surgical treatment of ulcerative colitis: ileorectal vs ileal pouch-anal anastomosis. World J Gastroenterol. 2014;20:13211–8.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Gastrointestinal and Oncologic Surgery, Surgical Director, Digestive Health Center, Northwestern Medicine James R. Professor of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Scott A. Strong MD, FACS, FASCRS (Chief)

Authors
  1. Scott A. Strong MD, FACS, FASCRS
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Scott A. Strong MD, FACS, FASCRS .

Editor information

Editors and Affiliations

  1. Medical Center, University of Chicago, Chicago, Illinois, USA

    Neil Hyman

  2. Medical Center, University of Chicago, Chicago, Illinois, USA

    Konstantin Umanskiy

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Strong, S.A. (2017). Which Ulcerative Colitis Patients Should Not Have Ileal Pouch-Anal Anastomosis. In: Hyman, N., Umanskiy, K. (eds) Difficult Decisions in Colorectal Surgery. Difficult Decisions in Surgery: An Evidence-Based Approach. Springer, Cham. https://doi.org/10.1007/978-3-319-40223-9_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-40223-9_6

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-40222-2

  • Online ISBN: 978-3-319-40223-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation