The Severity of Rectal Inflammation and Pouch Surgery Outcome in Patients with Ulcerative Colitis: A Retrospective Cohort Study.

IF 4.3 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Inflammatory Bowel Diseases Pub Date : 2025-09-16 DOI:10.1093/ibd/izaf194

Frederik Rud Windfeldt Bækgaard, Mie Dilling Kjær, Sören Möller, Stine Wikkelsøe Hovvang, Jens Kjeldsen, Rannveig Dora Baldursdottir, Sara Mehinovic, Sally Adham Al-Yousefy, Jakob Ravn Grimm, Mark Bremholm Ellebæk

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引用次数: 0

Abstract

Background: Pouch failure after ulcerative colitis (UC) necessitates either pouch excision or establishment of a permanent diverting stoma. The aim of this study was to explore if rectal inflammation prior to pouch creation affected the risk of developing pouch failure.

Methods: Patients 18 years and older with ulcerative colitis undergoing J-pouch surgery at Odense University Hospital between 1983 and 2020 were included. Pouch failure was defined as either the presence of ileostomy more than 1 year after ileo pouch-anal anastomosis (IPAA) or pouch removal. Rectal inflammation was defined by 3 measures: using the Nancy index on pathology examination of the resected rectum, endoscopically using latest Mayo score from the year preceding the IPAA, and as active anti-inflammatory treatment four weeks prior to IPAA.

Results: A total of 434 patients met the inclusion criteria, with 66 patients (15%) experiencing pouch failure with mean time of 5.63 years. Acute inflammation (Nancy grade 2-4) was observed in 70% of the patients. Active anti-inflammatory treatment was observed in 37% of patients, and 67% had undergone endoscopy within 1 year prior to IPAA. No significant association was found between the Nancy Index Grade and pouch failure, time to pouch failure, postoperative complications, or long-term pouch complications. Furthermore, neither the Mayo score grade nor active medical UC therapy predicted the risk of pouch failure.

Conclusion: Rectal inflammation prior to IPAA does not increase risk of pouch failure, postoperative complications, or long term pouch dysfunction.

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溃疡性结肠炎患者直肠炎症的严重程度和眼袋手术的预后：一项回顾性队列研究。

背景：溃疡性结肠炎（UC）后的眼袋失败需要切除眼袋或建立永久性转移造口。本研究的目的是探讨是否直肠炎症前形成的育儿袋影响风险发展育儿袋失败。方法：选取1983 ~ 2020年在欧登塞大学医院行j袋手术的18岁及以上溃疡性结肠炎患者。回肠袋-肛门吻合术（IPAA）后1年以上仍有回肠造口或切除回肠袋。采用3种方法定义直肠炎症：采用切除直肠病理检查的Nancy指数，内窥镜检查采用IPAA前一年最新的Mayo评分，以及IPAA前4周积极抗炎治疗。结果：434例患者符合纳入标准，66例（15%）患者出现眼袋衰竭，平均时间5.63年。70%的患者出现急性炎症（2-4级）。37%的患者接受了积极的抗炎治疗，67%的患者在IPAA前1年内接受了内窥镜检查。Nancy指数分级与眼袋失效、眼袋失效时间、术后并发症或长期眼袋并发症之间无显著相关性。此外，Mayo评分分级和积极的UC治疗都不能预测眼袋衰竭的风险。结论：IPAA术前的直肠炎症不会增加眼袋衰竭、术后并发症或长期眼袋功能障碍的风险。

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

Inflammatory Bowel Diseases 医学-胃肠肝病学

CiteScore

9.70

自引率

6.10%

发文量

462

审稿时长

1 months

期刊介绍： Inflammatory Bowel Diseases® supports the mission of the Crohn''s & Colitis Foundation by bringing the most impactful and cutting edge clinical topics and research findings related to inflammatory bowel diseases to clinicians and researchers working in IBD and related fields. The Journal is committed to publishing on innovative topics that influence the future of clinical care, treatment, and research.