Factors influencing the functional outcome of restorative proctocolectomy in ulcerative colitis

Background: Restorative proctocolectomy is considered to be the procedure o f choice in the operative treatment of ulcerative colitis. The aim of this study was to evaluate the functional outcome following operation and to ide ntify possible predictive factors. Methods: Some 168 patients (median age 32 years, 102 men) with ulcerative c olitis underwent restorative proctocolectomy. The functional outcome was ev aluated by a symptom index created from a questionnaire at a median of 29 ( 13-123) months of follow-up. The records of these patients were reviewed, a nd preoperative, peroperative and postoperative variables were registered a nd related to outcome. Results: The response rate to the questionnaire was 155 (92 per cent) of 16 8. The symptom index was related to patients' overall assessment of outcome . In spite of a perceived good result many patients experienced a number of symptoms. Age over 50 years (P < 0.01), presence of extraintestinal manife stations (P < 0.05) and late complications, such as anastomotic stricture ( P<0.05), pouchitis (P < 0.01) and anal pain(P < 0.05), were related to a le ss favourable outcome. Conclusion:While preoperative data may help in selecting patients suitable for restorative proctocolectomy, prevention of late complications seems mos t important in improving the functional outcome.