Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2026
Short- and long-term outcomes of IPAA for ulcerative colitis in Latin America: A retrospective, multicentre assessment.
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Surgical IBD LATAM Consortium
Аннотация
INTRODUCTION: Data on ileal pouch-anal anastomosis (IPAA) outcomes in ulcerative colitis (UC) patients from resource-constrained settings, such as Latin America, are limited. This study aimed to evaluate demographic characteristics, perioperative outcomes and long-term results of UC patients undergoing IPAA in Latin America.
METHODS: A retrospective analysis was conducted on UC patients who underwent IPAA at 11 academic centres across Argentina, Brazil, Chile and Colombia between 2012 and 2022. Main outcome was 30-day postoperative complications.
RESULTS: A total of 273 patients underwent IPAA; 49.8% were female, with a mean age of 37.5 years. Three-stage IPAA was performed in 68.9% of cases, while 31.1% underwent a two-stage approach. A minimally invasive technique was used in 50% of cases, with a 4% conversion rate. The 30-day complication rate was 36.6%, and 30-day mortality was 0.7%. On multivariate analysis, use of advanced therapies within 12 weeks of surgery was protective against postoperative complications (OR 0.24, p = 0.008), whereas ASA III/IV status was independently associated with higher complication rates (OR 5.14, p = 0.043). Long-term follow-up was available for 176 patients (median 60 months). IPAA-related complications occurred in 31.5%, including pouchitis, strictures, cuffitis and fistula formation. Pouch failure was observed in 8.5%.
CONCLUSION: IPAA for UC in Latin America shows acceptable morbidity, low mortality and long-term outcomes comparable to high-resource settings, supporting its feasibility in resource-constrained environments.
METHODS: A retrospective analysis was conducted on UC patients who underwent IPAA at 11 academic centres across Argentina, Brazil, Chile and Colombia between 2012 and 2022. Main outcome was 30-day postoperative complications.
RESULTS: A total of 273 patients underwent IPAA; 49.8% were female, with a mean age of 37.5 years. Three-stage IPAA was performed in 68.9% of cases, while 31.1% underwent a two-stage approach. A minimally invasive technique was used in 50% of cases, with a 4% conversion rate. The 30-day complication rate was 36.6%, and 30-day mortality was 0.7%. On multivariate analysis, use of advanced therapies within 12 weeks of surgery was protective against postoperative complications (OR 0.24, p = 0.008), whereas ASA III/IV status was independently associated with higher complication rates (OR 5.14, p = 0.043). Long-term follow-up was available for 176 patients (median 60 months). IPAA-related complications occurred in 31.5%, including pouchitis, strictures, cuffitis and fistula formation. Pouch failure was observed in 8.5%.
CONCLUSION: IPAA for UC in Latin America shows acceptable morbidity, low mortality and long-term outcomes comparable to high-resource settings, supporting its feasibility in resource-constrained environments.