Evidence map›Paper›PMID 30324385›Full record

ArticleEuropean radiology2019

Are radiologic pouchogram and pouchoscopy useful before ileostomy closure in asymptomatic patients operated for ulcerative colitis?

Georgios Exarchos, Linda Metaxa, Antonios Gklavas, Vassilis Koutoulidis, Ioannis Papaconstantinou

Abstract readEvaluation Study
PubMed Publisher
In one paragraph

Article in European radiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.4field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Preoperative anastomotic evaluation prior to ileostomy closure: A 5-year UK survey, systematic review, and meta-analysis.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2025
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4 · The record

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5 · Who and what money

Authors and funding

5 authors at 2 institutions in 2 countries.

Georgios Exarchos2nd Department of Surgery, National and Kapodistrian University of Athens - Aretaieion Hospital, 76 Vas. Sofias Ave., 11528, Athens, Greece. exarchos@doctors.org.uk.ORCID http://orcid.org/0000-0001-8093-1806
Linda MetaxaRadiology Department, St Bartholomew's Hospital, W Smithfield, EC1A 7BE, London, UK.
Antonios Gklavas2nd Department of Surgery, National and Kapodistrian University of Athens - Aretaieion Hospital, 76 Vas. Sofias Ave., 11528, Athens, Greece.
Vassilis KoutoulidisRadiology Department, National and Kapodistrian University of Athens, Aretaieion Hospital, Athens, Greece.
Ioannis Papaconstantinou2nd Department of Surgery, National and Kapodistrian University of Athens - Aretaieion Hospital, 76 Vas. Sofias Ave., 11528, Athens, Greece.
National and Kapodistrian University of Athens · GRSt Bartholomew's Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesRestorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the "gold standard" procedure for patients with ulcerative colitis (UC) requiring surgical intervention. A de-functioning ileostomy is usually performed, as a step for the IPAA procedure. The aim of this study is to present the methodology and results of the routine double assessment of IPAA integrity in asymptomatic patients prior to the ileostomy reversal and evaluate its necessity.

methodsThis is a retrospective study of 61 UC patients, who underwent IPAA construction, in 2010-2016. A diverting ileostomy was created after IPAA construction, which was reversed at least 3 months later. A double assessment, with pouchogram and pouchoscopy, of IPAA integrity was performed, before stoma closure. Post-operative symptoms and signs of complications, imaging studies, and endoscopic findings were recorded during follow-up.

resultsPrior to the ileostomy reversal, both pouchoscopy and pouchogram identified no patient with evidence of anastomotic leakage. During a mean follow-up of 3.67 years after ileostomy reversal, 11 patients developed complications but only one had signs of leakage, which presented as a pouch-vaginal fistula. The specificity of both the pouchogram and pouchoscopy reached 100% and the negative predictive value ranged between 98.4 and 100%.

conclusionsThe specificity of pouchoscopy and pouchogram prior to ileostomy closure, in asymptomatic patients with IPAA for UC, is very high in recognizing an intact anastomosis, but their combination did not alter the diagnostic accuracy or had any effect in further management. At least, pouchogram could be selectively performed only in patients with high-risk clinical indicators. KEY POINTS: • The double assessment of ileal pouch-anal anastomosis with pouchogram and pouchoscopy, prior to ileostomy closure, specifically in patients with ulcerative colitis has not been evaluated before. • The specificity of pouchoscopy and pouchogram prior to ileostomy closure, in asymptomatic patients with IPAA for UC, is very high in recognizing an intact anastomosis. • However, their combination did not alter the diagnostic accuracy or had any effect in further management, in asymptomatic patients.

Indexed as

Colonic PouchesAdolescentAdultAgedAnastomotic LeakColitis, UlcerativeEndoscopy, GastrointestinalFemaleFluoroscopyHumansIleostomyMaleMiddle AgedPostoperative ComplicationsPreoperative CareProctocolectomy, RestorativeEndoscopy, gastrointestinalFluoroscopyIleal pouch-anal anastomosisProctocolectomy, restorativeUlcerative colitis

Identifiers

PMID30324385
OpenAlexW2897847399

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.