TY  - JOUR
A1  - Frese, Jan P.
A1  - Gröne, Jörn
A1  - Lauscher, Johannes C.
A1  - Kreis, Martin E.
A1  - Weixler, Benjamin
A1  - Beyer, Katharina
A1  - Seifarth, Claudia
T1  - Inflammation of the rectal remnant endangers the outcome of ileal pouch-anal anastomosis: a case–control study
T2  - International Journal of Colorectal Disease
N2  - Background: Inflammation of the rectal remnant may affect the postoperative outcome of ileal pouch-anal anastomosis (IPAA) in patients with ulcerative colitis (UC). We aimed to determine the extent of inflammation in the anastomotic area during IPAA and to investigate the impact of proctitis on postoperative complications and long-term outcomes. 

Methods: Three hundred thirty-four UC patients with primary IPAA were included in this retrospective case–control study. The histopathologic degree of inflammation in the anastomotic area was graded into three stages of no proctitis (“NOP”), mild to medium proctitis (“MIP”), and severe proctitis (“SEP”). Preoperative risk factors, 30-day morbidity, and follow-up data were assessed. Kaplan–Meier analysis was performed in the event of pouch failure. 

Results: The prevalence of proctitis was high (MIP 40.4%, and SEP 42.8%). During follow-up, the incidence of complications was highest among SEP: resulting in re-intervention (n = 40; 28.2%, p = 0.017), pouchitis (n = 36; 25.2%, p < 0.01), and pouch failure (n = 32; 22.4%, p = 0.032). The time interval to pouch failure was 5.0 (4.0–6.9) years among NOP, and 1.2 (0.5–2.3) years in SEP (p = 0.036). ASA 3, pouchitis, and pouch fistula were independent risk factors for pouch failure. Conclusion Proctitis at the time of IPAA is common. A high degree of inflammation is associated with poor long-term outcomes, an effect that declines over time. In addition, a higher degree of proctitis leads to earlier pouch failure.
Y1  - 2022
UR  - https://opus.bibliothek.uni-augsburg.de/opus4/frontdoor/index/index/docId/123773
UR  - https://nbn-resolving.org/urn:nbn:de:bvb:384-opus4-1237734
SN  - 1432-1262
VL  - 37
IS  - 7
SP  - 1647
EP  - 1655
PB  - Springer Science and Business Media LLC
ER  -