Imperial College London
Portrait Picture

ProfessorParisTekkis

Faculty of Medicine, Department of Surgery & Cancer

Professor of Colorectal Surgery
 
 
 
//

Contact

 

+44 (0)20 3315 8529p.tekkis Website

 
 
//

Location

 

Area DChelsea and Westminster HospitalChelsea and Westminster Campus

//

Summary

 

Publications

Citation

BibTex format

@article{Ramage:2016:10.1007/s00384-015-2475-4,
author = {Ramage, L and Qiu, S and Georgiou, P and Tekkis, P and Tan, E},
doi = {10.1007/s00384-015-2475-4},
journal = {International Journal of Colorectal Disease},
pages = {481--492},
title = {Functional outcomes following ileal pouch-anal anastomosis (IPAA) in older patients: a systematic review},
url = {http://dx.doi.org/10.1007/s00384-015-2475-4},
volume = {31},
year = {2016}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - 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
AU  - Ramage,L
AU  - Qiu,S
AU  - Georgiou,P
AU  - Tekkis,P
AU  - Tan,E
DO  - 10.1007/s00384-015-2475-4
EP  - 492
PY  - 2016///
SN  - 1432-1262
SP  - 481
TI  - Functional outcomes following ileal pouch-anal anastomosis (IPAA) in older patients: a systematic review
T2  - International Journal of Colorectal Disease
UR  - http://dx.doi.org/10.1007/s00384-015-2475-4
UR  - http://hdl.handle.net/10044/1/39425
VL  - 31
ER  -
Download