Perioperative resting pressure predicts long-term postoperative function after ileal pouch-anal anastomosis |
| |
Authors: | Amy L Halverson MD Tracy L Hull MD Feza Remzi MD Jeffery P Hammel Tom Schroeder MD Victor W Fazio MD |
| |
Institution: | (1) Department of Colorectal Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio;(2) Department of Biostatistics, The Cleveland Clinic Foundation, Cleveland, Ohio;(3) Department of Colorectal Surgery, 9500 Euclid Ave., Desk A-30, 44195 Cleveland, OH |
| |
Abstract: | The purpose of this study was to determine whether perioperative manometry is useful in predicting long-term functional status
after ileal pouch-anal anastomosis (IPAA). Prospectively collected perioperative anal manometry data from 1439 patients undergoing
IPAA from 1986 to 2000 were compared to postoperative functional status at various time intervals from 6 months to 8 years
after IPAA. A validated questionnaire was used to obtain information regarding restrictions of diet, work, social and sexual
activity, urgency, fecal seepage or incontinence, energy level, satisfaction with surgery, and quality of life. The presence
of seepage and the degree of incontinence were compared to the patient’s perceived quality of life, health, energy level,
and satisfaction with surgery. Low (<40 mm Hg) pre- and postoperative resting pressures were associated with increased seepage,
pad use, and incontinence. Patients with low resting pressures also reported diminished quality of life, health, energy level,
and satisfaction with surgery. There was a significant association (P < 0.001) between seepage and degree of incontinence and quality of health, quality of life, energy level, and level of satisfaction
with surgery. Perioperative resting anal sphincter pressures greater than 40 mm Hg are associated with significantly better
function and quality of life after ileal IPAA. Improved functional outcome is associated with better quality-of-life outcomes.
Low preoperative resting pressures do not preclude successful outcome after IPAA.
Presented at the Forty-Second Annual Meeting of The Society for Surgery of the Alimentary Tract, Atlanta, Georgia, May 20–23,
2001 (oral presentation). |
| |
Keywords: | Ileal pouch manometry function incontinence anastomosis |
本文献已被 SpringerLink 等数据库收录! |
|