SynthesisInternational journal of colorectal disease2016
Functional outcomes following ileal pouch-anal anastomosis (IPAA) in older patients: a systematic review.
Synthesis in International journal of colorectal disease, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
15 citing papers in PubMed, 31 citations in OpenAlex.
- Long-term functional outcome and quality of life after ileal pouch anal anastomosis: retrospective, tertiary-center study, over 19 years.Langenbeck's archives of surgery · 2025Article
- Creation of an institutional preoperative checklist to support clinical risk assessment in patients with ulcerative colitis (UC) considering ileoanal pouch surgery.Frontline gastroenterology · 2024Article
- Sarcopenia and frailty in inflammatory bowel disease: Emerging concepts and evidence.JGH open : an open access journal of gastroenterology and hepatology · 2024Review
- Ileal Pouch-Anal Anastomosis in the Older Adult: a Review of Postoperative Outcomes and Pouchitis Treatment.Current treatment options in gastroenterology · 2022Article
- Restorative proctocolectomy with ileal pouch-anal anastomosis in elderly patients - is advanced age a contraindication?ANZ journal of surgery · 2022Article
- The Optimal Ileal Pouch: Physiologic Parameters Significantly Correlate with Overall Pouch Function.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Article
- Bowel Function After J-Pouch May Be More Complex Than Previously Appreciated: A Comprehensive Analysis to Highlight Existing Knowledge Gaps.Diseases of the colon and rectum · 2020Article
- Chronic Antibiotic Dependent Pouchitis Is Associated With Older Age at the Time of Ileal Pouch Anal Anastomosis (J-pouch) Surgery.Crohn's & colitis 360 · 2019Article
- Management of elderly ulcerative colitis in Japan.Journal of gastroenterology · 2019Review
- Post-surgical fecal incontinence.Updates in surgery · 2018Article
- Outcomes and Management of the Ileal Pouch-Anal Anastomosis in the Elderly.Current treatment options in gastroenterology · 2018Review
- Impact of sex on 30-day complications and long-term functional outcomes following ileal pouch-anal anastomosis for chronic ulcerative colitis.International journal of colorectal disease · 2018Article
- The functional outcome and factors influencing the quality of life after ileal pouch anal anastomosis in patients with ulcerative colitis.Surgery today · 2018Article
- When Not to Pouch: Important Considerations for Patient Selection for Ileal Pouch-Anal Anastomosis.Gastroenterology & hepatology · 2017Article
- Impact of staged surgery on quality of life in refractory ulcerative colitis.Surgical endoscopy · 2017Observational
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimIleal pouch-anal anastomosis (IPAA) is performed in ulcerative colitis or familial adenomatous polyposis with a view to restoration of GI continuity and prevention of permanent faecal diversion. Debate exists as to its safety in older patients. This review aims to assess functional outcomes and safety of restorative proctocolectomy (RPC) in older compared to younger patients.
methodsLiterature search was performed for age-stratified studies which assessed functional outcomes of IPAA. Twelve papers were included overall. Patients were categorized into 'older' and 'younger' groups. Analysis was split into three separate parts: 1. Age cut-off of 50 ± 5 years (with sensitivity analysis); 2. Age cut-off of 65 ± years; 3. Long-term outcomes (>10 years).
resultsWith an age cut-off of 50 years (4327 versus 513 patients), complication rates were comparable with the exception of an increased rate of small-bowel obstruction in the younger patients (p = 0.034). At 1 year, 24-h stool frequency was significantly higher in the older patient group (p < 0.0001). Daytime (p < 0.0001) and night-time (p < 0.0001) incontinence rates were also significantly higher in older patients. Overall, function deteriorated with time across all ages; however, after 10 years, there was no significant difference in incontinence rates between age groups. Dehydration and electrolyte loss was a significant problem in patients over 65 (p < 0.0001). Despite differences in postoperative function, quality of life was comparable between groups; however, only a few studies reported quality of life data.
conclusionIPAA is safe in older patients, although treating clinicians should bear in mind the increased risk of dehydration. Postoperative function is worse in older patients, but seems to level out with time and does not appear to significantly impact on overall quality of life and patient satisfaction. Assessment for suitability for RPC should not be based on chronological age in isolation. It is imperative that the correct support is given to older patients with worsened postoperative function in order to maintain patient satisfaction and adequate quality of life.
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