Quality of life after ileoanal pouch: A comparison of J and W pouches

Introduction: Standard treatment for ulcerative colitis and prevention of malignancy is total proctocolectomy with a neoileal pouch. The ideal configuration of the pouch has been debated. We hypothesized that there was no difference in quality of life between the J pouch and the W pouch. Material and Methods: We retrospectively reviewed the medical records of all patients undergoing ileoanal anastomosis with pouch construction at a single community-based teaching hospital over an 11+-year period. We collected demographic, operative, and postoperative data and then developed and distributed a survey designed to assess patient quality of life following pouch construction. The data of patients who had J pouches were then compared with those of patients who had W pouches. Forty-nine patients were identified; 30 had J pouches and 19 had W pouches. Results: The groups did not differ significantly in age, sex, or indication for surgery. Significant differences were detected in readmission rates (J∈=∈63%, W∈=∈21%; p∈=∈0.004) and length of follow-up (J∈=∈61 months, W∈=∈117 months; p∈=∈0.001). Complication rates, length of stay, and conversion to end ileostomy rates were similar between groups. Self-reported health status, activity restrictions, urgency, seepage, protective pad use, and number of bowel movements at night were also similar. A significant difference existed in number of bowel movements per day (J∈=∈6, W∈=∈4.5, p∈=∈0.041). No difference in quality of life was found between groups. Subgroup analysis of ulcerative-colitis-only patients had no effect on results. Conclusion: Because the J pouch is less technically demanding, it should be the preferred configuration.