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- Title
Gender of the patient may influence perioperative and long-term complications after restorative proctocolectomy.
- Authors
Rottoli, M.; Remzi, F. H.; Shen, B.; Kiran, R. P.
- Abstract
Aim Gender-related differences in preoperative characteristics and early and long-term outcome for patients undergoing ileal pouch anal anastomosis (IPAA) have not previously been well studied. Method All male and female patients undergoing IPAA at a single centre between 1983 and 2008 were compared for perioperative variables and long-term outcome. Statistical tests were used as appropriate. A multivariate analysis was performed to evaluate the effects of gender on pouch failure. Results Female patients ( n = 1495) were younger than male patients ( n = 1912) ( P < 0.001). Surgery type and pouch configuration were similar, although male gender was associated with a higher use of ileostomy ( P < 0.001) and a higher incidence of 30-day anastomotic separation ( P = 0.001). During a median follow up of 9.9 (female) and 9.3 (male) years, female patients were more likely to develop bowel obstruction (20.8 vs 16.7%, P = 0.02) and pouch-related fistula (10.9 vs 7.6%, P = 0.001). Women had a higher number of daily bowel movements than men ( P = 0.001), and more frequently had urgency ( P = 0.001), daily seepage ( P = 0.01) and pad use ( P < 0.001). A higher percentage of female patients reported dietary ( P < 0.001) and work ( P = 0.022) restrictions and lower mental component of the Short-Form 36 quality of life score ( P = 0.018). On multivariate analysis of perioperative variables, female gender was associated with pouch failure ( P = 0.05). Conclusion The gender of the patient seems to be associated with specific differences in preoperative variables and postoperative outcomes for patients undergoing IPAA.
- Subjects
RESTORATIVE proctocolectomy; RECTAL surgery; SURGICAL complications; SURGICAL anastomosis; MULTIVARIATE analysis; ILEOSTOMY
- Publication
Colorectal Disease, 2012, Vol 14, Issue 3, p336
- ISSN
1462-8910
- Publication type
Article
- DOI
10.1111/j.1463-1318.2011.02634.x