Ileal pouch anal anastomosis in the elderly: A systematic review and meta-analysis.

Ileal pouch anal anastomosis in the elderly: A systematic review and meta-analysis.

Pedersen KE; Jia X; Holubar SD; Steele SR; Lightner AL

Colorectal Disease

2021

2021-04-07

AIM: Despite good overall outcomes in most patients undergoing ileal pouch anal anastomosis (IPAA), there is still hesitation in performing an IPAA in older patients due to comorbidity burden and concern for incontinence. We aimed to identify short- and long-term outcomes in older patinets undergoing IPAA to determine the peri-operative safety and long-term functional success of IPAA in older patients. METHODS: A literature search was performed for all publications of IPAA in adults ≥50 years old that reported short- and long-term outcomes. Data extraction included demographics, 30-day outcomes, long-term functional outcomes, and pouch failure. Data was further separated by age group (50-65 and ≥65 years old). Outcomes were compared between age groups. Study quality and risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). RESULTS: Of 1,053 publications reviewed, 13 full papers were included in the analysis. The overall 30-day morbidity and mortality rates were 47.3% and 1.3%, respectively. Thirty-day postoperative rates of small bowel obstruction and pelvic sepsis were 7.6% and 9.9%, respectively. After a median follow-up time of 62 months, rates of pouchitis, incontinence, and pouch failure were 13.9%, 17.5%, 7.5%, respectively. There was no statically significant difference in rates of short- or long-term functional outcomes based on age 50-65 versus ≥65 years. CONCLUSION: Increasing age did not increase the rate of short- or long-term outcomes including pouch failure. These data suggest the decision for IPAA construction should not be based on age alone. What does this paper add to the literature? This paper compiles data on outcomes of IPAA construction in elderly patients to underscore age alone does no increase rates of pouch failure.

elderly; FAP; functional outcomes; IPAA; UC

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