Literature DB >> 21689322

Gender of the patient may influence perioperative and long-term complications after restorative proctocolectomy.

M Rottoli1, F H Remzi, B Shen, R P Kiran.   

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.
© 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland.

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Year:  2012        PMID: 21689322     DOI: 10.1111/j.1463-1318.2011.02634.x

Source DB:  PubMed          Journal:  Colorectal Dis        ISSN: 1462-8910            Impact factor:   3.788


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