Perioperative enhanced recovery program implementation improves clinical outcomes in patients with ulcerative colitis after total proctocolectomy with ileal pouch-anal anastomosis.

IF 2.5 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

International Journal of Colorectal Disease Pub Date : 2025-02-13 DOI:10.1007/s00384-025-04824-x

Wenjun Ding, Zhujiang Dai, Long Cui, Xiaojian Wu, Wei Zhou, Zhao Ding, Weimin Xu, Peng Du

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引用次数: 0

Abstract

Background: Total proctocolectomy with ileal pouch-anal anastomosis (IPAA) is widely regarded as a definitive surgical option for managing ulcerative colitis (UC). Enhanced recovery programs (ERP) have shown potential in better outcomes following surgery; however, their perioperative benefits in UC patients undergoing IPAA remain insufficiently investigated.

Methods: This study included UC patients who underwent IPAA between January 2008 and September 2023 across multiple affiliated centers within the China UC Pouch Center Union. Key outcomes analyzed included postoperative complications and long-term quality of life (QOL), assessed via the comprehensive complication index (CCI) and Cleveland Global Quality of Life (CGQL) instrument.

Results: A total of 216 patients were included, with a median follow-up of 8.0 years (interquartile range, 4.0-11.0 years); 62 patients underwent comprehensive ERP. Results indicated that ERP implementation significantly lowered CCI scores (p = 0.036), reduced the incidence of severe complications (CCI > 26.2, p = 0.019), shortened hospital stays (p = 0.046), and improved long-term QOL (p < 0.001). Non-adherence to ERP emerged as an independent risk factor for severe postoperative complications (odds ratio, 3.195; 95% confidence interval, 1.332-7.664; p = 0.009) and impaired QOL (odds ratio, 3.222; 95% confidence interval, 1.462-7.101; p = 0.004).

Conclusion: Our study provided supporting evidence for the application of perioperative ERP in a specific homogeneous cohort of UC patients undergoing IPAA to further improve clinical outcomes for them.

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围手术期增强恢复方案的实施改善了溃疡性结肠炎患者全直结肠切除术回肠袋肛管吻合术后的临床结果。

背景：全直结肠切除术联合回肠袋-肛门吻合术（IPAA）被广泛认为是治疗溃疡性结肠炎（UC）的最终手术选择。增强恢复计划（ERP）显示出手术后更好结果的潜力；然而，它们在UC患者接受IPAA的围手术期的益处仍然没有充分的研究。方法：本研究包括2008年1月至2023年9月在中国UC眼袋中心联盟多个附属中心接受IPAA的UC患者。分析的主要结果包括术后并发症和长期生活质量（QOL），通过综合并发症指数（CCI）和克利夫兰全球生活质量（CGQL）仪器进行评估。结果：共纳入216例患者，中位随访时间为8.0年（四分位数范围为4.0-11.0年）；62例患者行全面ERP。结果表明，ERP的实施显著降低了CCI评分（p = 0.036），降低了严重并发症的发生率（CCI bb0 26.2, p = 0.019），缩短了住院时间（p = 0.046），改善了长期生活质量(p)。结论：我们的研究为在特定的同质UC患者IPAA中应用围手术期ERP进一步改善其临床预后提供了支持证据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Colorectal Disease 医学-外科

CiteScore

4.90

自引率

3.60%

发文量

206

审稿时长

3-8 weeks

期刊介绍： The International Journal of Colorectal Disease, Clinical and Molecular Gastroenterology and Surgery aims to publish novel and state-of-the-art papers which deal with the physiology and pathophysiology of diseases involving the entire gastrointestinal tract. In addition to original research articles, the following categories will be included: reviews (usually commissioned but may also be submitted), case reports, letters to the editor, and protocols on clinical studies. The journal offers its readers an interdisciplinary forum for clinical science and molecular research related to gastrointestinal disease.