RECOVERY OF ANAL-SPHINCTER FUNCTION AFTER THE ILEOANAL RESERVOIR PROCEDURE IN PATIENTS OVER THE AGE OF 50

PURPOSE: This study was undertaken to postoperatively assess the progr ession of anal sphincter function and clinical outcome in patients gre ater than or equal to 50 years old (Group I) compared with those < 50 years old (Group II). METHODS: Clinical data were assessed after ileos tomy closure by a questionnaire. These data were compiled to obtain an incontinence score, which ranged from 0 (perfect continence) to 20 (t otal incontinence). Anorectal manometry was performed preoperatively ( MN1) and postoperatively, before (MN2) and after (MN3) ileostomy closu re. Wilcoxon and paired t-test were used to compare the clinical and f unctional results, respectively. RESULTS: Group I consisted of 22 pati ents (mean age, 56 years) and Group II, 50 patients (mean age, 32 year s). No differences were found relative to either preoperative pressure s or clinical outcome. However, both the mean and high resting pressur es were significantly lower in Group I at the MN2 examination. CONCLUS ION: The effect on anal sphincters of ileoanal reservoir in patients o ver the age of 50 years is similar to that noted in younger patients. Transient impairment of internal anal sphincter function observed afte r ileoanal reservoir is more severe in older patients (P = 0.01). Howe ver, as in younger patients, it does completely recover after ileostom y closure.