Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver · 2025
Pouch function assessment with dynamic magnetic resonance defecography after ileal pouch anal anastomosis for ulcerative colitis.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Wang Jiansheng, Xu Yi, Zhang Tenghui, Zheng Sizhe, Luo Song, Ma Yan, Zhu Feng, Zhou Changsheng, Gong Jianfeng
Аннотация
BACKGROUND: Ulcerative colitis (UC) patients undergoing ileal pouch anal anastomosis (IPAA) will potentially have abnormal pouch function, which seriously affects their quality of life. It is usually attributed to postoperative pouch structural complications. However, symptoms of poor pouch function also occur in patients with "normal pouch". Few objective tools have been used to evaluate the pouch function with non-optimal pouch physiology.
AIM: To investigate the validity of dynamic magnetic resonance defecography (DMRD) and its relationship with pouch function in UC patients undergoing IPAA.
METHODS: UC patients who had IPAA surgery were recruited. Patients with structural complications were excluded. Patients were assessed by questionnaires for pouch function including ileal pouch syndrome severity (IPSS) score. DMRD was performed at resting, raising, and defecation phase. The correlation between DMRD data and pouch function was investigated. Poor pouch function was defined as IPSS score >15.
RESULTS: A total of 33 patients were included. The results showed that distance from anastomosis to pubococcygeal line (PCL) at rest phase was an independent risk factor for poor pouch function ([OR] 5.65, 95 % CI 1.02-31.16, P = 0.047). The length of cuff at raising phase was an independent risk factor for urgency ([OR] 12.55, 95 % CI 1.06-148.32, P = 0.045). In addition, M-line length-a reference for assessing pelvic floor descent (normal ≤2 cm)-during defecation was an independent risk factor for incomplete defecation ([OR] 2.47, 95 % CI 1.11-5.47, P = 0.027), while M-line length at rest was an independent risk factor for stool leakage ([OR] 10.16, 95 % CI 1.15-90.07, P = 0.037).
CONCLUSIONS: Magnetic resonance defecography is a potentially useful imaging modality for evaluating pouch function. Our study presented a series of DMRD parameters for functional assessment and their association with defecation disorders during dynamic monitoring. Therefore, DMRD provides information, in addition to clinical parameters, in symptomatic pouch patients.
AIM: To investigate the validity of dynamic magnetic resonance defecography (DMRD) and its relationship with pouch function in UC patients undergoing IPAA.
METHODS: UC patients who had IPAA surgery were recruited. Patients with structural complications were excluded. Patients were assessed by questionnaires for pouch function including ileal pouch syndrome severity (IPSS) score. DMRD was performed at resting, raising, and defecation phase. The correlation between DMRD data and pouch function was investigated. Poor pouch function was defined as IPSS score >15.
RESULTS: A total of 33 patients were included. The results showed that distance from anastomosis to pubococcygeal line (PCL) at rest phase was an independent risk factor for poor pouch function ([OR] 5.65, 95 % CI 1.02-31.16, P = 0.047). The length of cuff at raising phase was an independent risk factor for urgency ([OR] 12.55, 95 % CI 1.06-148.32, P = 0.045). In addition, M-line length-a reference for assessing pelvic floor descent (normal ≤2 cm)-during defecation was an independent risk factor for incomplete defecation ([OR] 2.47, 95 % CI 1.11-5.47, P = 0.027), while M-line length at rest was an independent risk factor for stool leakage ([OR] 10.16, 95 % CI 1.15-90.07, P = 0.037).
CONCLUSIONS: Magnetic resonance defecography is a potentially useful imaging modality for evaluating pouch function. Our study presented a series of DMRD parameters for functional assessment and their association with defecation disorders during dynamic monitoring. Therefore, DMRD provides information, in addition to clinical parameters, in symptomatic pouch patients.