Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2025
Postoperative outcomes of a pelvic pouch procedure: Lessons learned over 40 years among 5070 patients.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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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.
Lavryk Olga, Maspero Marianna, Holubar Stefan D, Kanters Arielle, Liska David, Valente Michael A, Lipman Jeremy M, Kessler Hermann, Steele Scott R, Hull Tracy L
Аннотация
BACKGROUND: This study aimed to report the experience over 40 years and outcomes of 5070 patients who underwent a pelvic pouch procedure.
METHODS: A retrospective analysis of a prospectively maintained ileal pouch-anal anastomosis (IPAA) database (1983-2022) was performed. Patients were stratified based on the following diagnoses: ulcerative colitis (UC), indeterminate colitis (IC), familial adenomatous polyposis (FAP), inflammatory bowel disease (IBD)-dysplasia, Crohn colitis (CD), and others. The long-term IPAA outcomes, quality of life, and satisfaction with IPAA over time were studied.
RESULTS: The Kaplan-Meier pouch survival rates at 20 years based on the diagnosis were as follows: 92% (95% CI, 90%-94%) for UC, 87% (95% CI, 81%-94%) for CD, 95% (95% CI, 92%-99%) for FAP, and 92% (95% CI, 89%-96%) for IC. Of the patients with UC, 28% developed pouchitis, 12% developed anastomotic stricture, and 13% developed small bowel obstruction. Patients with IC had the highest rate of pouchitis (347 [37%]) and IPAA strictures (154 [17%]). Patients with CD had the highest rate of fistula (26 [15%]). Patients with FAP had the highest rate of obstruction (41 [25%]). The social lifestyle restrictions were predominant among patients with FAP (20%) compared with those with UC (12%) or CD (13%) (P =.004). The median stool frequency was 6 (IQR, 5-8) among the groups (P =.46).
CONCLUSION: Patients with an IBD diagnosis and IPAA were at an increased risk of pouch-associated complications, such as pouchitis, strictures, and pelvic sepsis. Patients with FAP had the best pouch survival with significantly lower rates of pouch-associated complications.
METHODS: A retrospective analysis of a prospectively maintained ileal pouch-anal anastomosis (IPAA) database (1983-2022) was performed. Patients were stratified based on the following diagnoses: ulcerative colitis (UC), indeterminate colitis (IC), familial adenomatous polyposis (FAP), inflammatory bowel disease (IBD)-dysplasia, Crohn colitis (CD), and others. The long-term IPAA outcomes, quality of life, and satisfaction with IPAA over time were studied.
RESULTS: The Kaplan-Meier pouch survival rates at 20 years based on the diagnosis were as follows: 92% (95% CI, 90%-94%) for UC, 87% (95% CI, 81%-94%) for CD, 95% (95% CI, 92%-99%) for FAP, and 92% (95% CI, 89%-96%) for IC. Of the patients with UC, 28% developed pouchitis, 12% developed anastomotic stricture, and 13% developed small bowel obstruction. Patients with IC had the highest rate of pouchitis (347 [37%]) and IPAA strictures (154 [17%]). Patients with CD had the highest rate of fistula (26 [15%]). Patients with FAP had the highest rate of obstruction (41 [25%]). The social lifestyle restrictions were predominant among patients with FAP (20%) compared with those with UC (12%) or CD (13%) (P =.004). The median stool frequency was 6 (IQR, 5-8) among the groups (P =.46).
CONCLUSION: Patients with an IBD diagnosis and IPAA were at an increased risk of pouch-associated complications, such as pouchitis, strictures, and pelvic sepsis. Patients with FAP had the best pouch survival with significantly lower rates of pouch-associated complications.