Ileal Pouch Anal Anastomosis (IPAA) for colitis; development of Crohn's and Pouchitis - 20/06/22
, Tyler Wall b, Aqieda Bayat b, Martin Luchtefeld a, b, c, James W. Ogilvie a, b, cAbstract |
Background |
Chronic pouchitis and Crohn's disease after Ileal pouch anal anastomosis (IPAA) for ulcerative colitis could be a larger issue than previously reported.
Methods |
All patients receiving care for their IPAA over a 10-year period at a community hospital were included. Primary outcomes were incidence of Crohn's disease and pouchitis.
Results |
The study included 380 IPAA patients. Indication for pouch creation was either UC (n = 362) or indeterminate colitis (n = 18). Cumulative incidence of Crohn's was 19.5%. Five-, 10- and 20-year incidence of Crohn's was 3.4%, 8.4% and 16.9%. Chronic pouchitis occurred in 28.7%. Mean time to pouchitis and Crohn's diagnosis was 8.4 (SD ± 8.0) and 11.6 (SD ± 7.5) years. Pouch failure occurred in 12.4%. Patients who developed Crohn's were more likely to suffer pouchitis and pouch failure (OR 3.5, 95%CI 2.0–6.0 and 5.3, 95%CI 2.8–10.1).
Conclusion |
During long term follow up, almost 20% are diagnosed with Crohn's contributing significantly to pouch failure.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Long term incidence of Crohn's disease of the pouch was 19.5%. |
• | Chronic and/or antibiotic refractory pouchitis affected 28.7%. |
• | Pouch failure occurred in 12.4% of which 38% were due to de novo Crohn's of the pouch. |
Keywords : Proctocolectomy, Restorative, Crohn's disease, Colitis, Ulcerative, Pouchitis
Plan
Vol 224 - N° 1PB
P. 453-458 - juillet 2022 Retour au numéro
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