Institutional members access full text with Ovid®

Share this article on:

Long-term Functional and Quality-of-Life Outcomes After IPAA in Children

Zmora, Osnat M.D.1; Natanson, Maya2; Dotan, Iris M.D.3; Vinograd, Itzhak M.D.1; Nagar, Hagith M.D.1; Rabau, Micha M.D.2; Tulchinsky, Hagit M.D.2,3

doi: 10.1097/DCR.0b013e3182753e10
Original Contribution: Inflammatory Bowel Disease

BACKGROUND: The impact of IPAA on long-term outcomes in adults is favorable. Studies on functional outcome and quality of life in children are sparse.

OBJECTIVE: The aim of this study was to evaluate the functional and quality-of-life outcomes after IPAA in children and to investigate the possible correlations between the two.

DESIGN: Standardized validated questionnaires of bowel/psychosocial functioning and quality of life were used to assess outcome.

SETTING: This study was conducted at a tertiary medical center.

PATIENTS: All children who had surgery at <18 years of age and were followed up at our institute were included. Global Assessment of Function Scale questionnaires were used to evaluate functional outcome. Quality of life in patients >18 years at the time of follow-up was scored by using the Short Form 36 questionnaire completed by the patients. Quality of life in the younger patients at the time of follow-up was scored using the Child Health Questionarie-28 filled by the parents.

RESULTS: Data were obtained in 26 patients (25 with a preoperative diagnosis of ulcerative colitis) at a median follow-up of 6 years. The median age at surgery was 15 years. Quality of life was comparable to the general population for children >18 at the time of follow-up in 7 of 8 items, but was lower than in the general population in 7 of 12 items for those who were younger at the time of follow-up. The mean functional score was found to be negatively correlated to all 8 Short Form 36 parameters (r > 0.5; p < 0.005), but only to one of the Child Health Questionarie-28 parameters.

LIMITATIONS: This study was limited by its small sample size.

CONCLUSIONS: The functional outcomes among pediatric patients undergoing IPAA are good. Parents’ perception of their child’s quality of life is poorer in comparison with the perception by patients themselves when older and with no correlation to the functional results.

1 Department of Pediatric Surgery, Dana Children’s Hospital, Tel-Aviv Sourasky Medical Center, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel

2 Proctology Unit, Department of Surgery, Tel-Aviv University, Tel-Aviv, Israel

3 Comprehensive Pouch Clinic, IBD Center, Department of Gastroenterology and Liver Diseases, Tel-Aviv University, Tel-Aviv, Israel

Financial Disclosures: None reported.

Osnat Zmora and Maya Natanson contributed equally to this article.

This work was performed in partial fulfilment of the M.D. thesis requirements of the Sackler Faculty of Medicine, Tel Aviv University for Maya Natanson.

Correspondence: Hagit Tulchinsky, M.D., Proctology Unit, Department of Surgery, Tel Aviv Sourasky Medical Center, 6 Weizman St, Tel-Aviv 64239, Israel. E-mail:

© The ASCRS 2013