Ileal Pouch-Anal Anastomosis in the Older Adult: a Review of Postoperative Outcomes and Pouchitis Treatment.
IPAA
Older adults
Proctocolectomy
Ulcerative colitis
Journal
Current treatment options in gastroenterology
ISSN: 1092-8472
Titre abrégé: Curr Treat Options Gastroenterol
Pays: United States
ID NLM: 9815941
Informations de publication
Date de publication:
Dec 2022
Dec 2022
Historique:
entrez:
27
2
2023
pubmed:
28
2
2023
medline:
28
2
2023
Statut:
ppublish
Résumé
Ileal pouch-anal anastomosis (IPAA) has become the preferred surgical treatment for patients with medically refractive ulcerative colitis (UC). Previous studies have suggested that outcomes of this procedure may be worse in older patients; however, more recent reports have suggested that IPAA in select patients is safe, feasible, and results in good quality of life. In this review, we discuss the recent literature surrounding clinical considerations and treatment management of IPAA in older adults. IPAA complication rates and adverse events are similar in the older adult population, as compared to the younger adult patient population. Although fecal urgency and incontinence may be more common among older adults, chronological age alone is not a contraindication for IPAA surgery, as good quality of life can still be achieved. In this review, we will also discuss the development of pouchitis after IPAA, particularly among older adults, as the emergence of newer biologic drugs has shifted the treatment landscape. IPAA can be a safe and effective treatment modality for older adults with UC, with high self-reported patient satisfaction. Patient optimization and careful case selection are vital to achieving these outcomes, and specialized preoperative assessments and counseling can help facilitate the proper treatment.
Identifiants
pubmed: 36844648
doi: 10.1007/s11938-022-00405-x
pmc: PMC9957085
mid: NIHMS1869036
doi:
Types de publication
Journal Article
Langues
eng
Pagination
564-581Subventions
Organisme : NIA NIH HHS
ID : R03 AG078927
Pays : United States
Déclaration de conflit d'intérêts
Conflict of Interest Sabrina L. Chen declares that she has no conflict of interest. Adam S. Faye declares that he has no conflict of interest. Shannon Chang declares that she has no conflict of interest.
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