ArticleInternational journal of colorectal disease2019
Comparable perioperative outcomes, long-term outcomes, and quality of life in a retrospective analysis of ulcerative colitis patients following 2-stage versus 3-stage proctocolectomy with ileal pouch-anal anastomosis.
Article in International journal of colorectal disease, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 3 of them syntheses that pooled it.
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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.
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Who cites it
20 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Transanal ileal pouch-anal anastomosis: A systematic review and meta-analysis of technical approaches and clinical outcomes.Langenbeck's archives of surgery · 2024Pooled it
- Risks Factors Associated with the Development of Crohn's Disease After Ileal Pouch-Anal Anastomosis for Ulcerative Colitis: A Systematic Review and Meta-Analysis.Journal of Crohn's & colitis · 2023Pooled it
- Prevalence of 'pouch failure' of the ileoanal pouch in ulcerative colitis: a systematic review and meta-analysis.International journal of colorectal disease · 2022Pooled it
- A network meta-analysis comparing laparoscopic, open and robotic restorative proctocolectomy with ileal pouch-anal anastomosis [IPAA].Updates in surgery · 2026Article
- Managing Acute Severe Ulcerative Colitis in 2025 and Beyond.Current gastroenterology reports · 2026Review
- Long-term mental and physical quality of life outcomes following ileal pouch anal anastomosis surgery.Annals of the Royal College of Surgeons of England · 2025Article
- 2-Stage and 3-stage restorative proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis show comparable short- and long-term outcomes.Scientific reports · 2024Article
- Two-step versus three-step proctocolectomy for ulcerative colitis: a comparative study on nutritional status, immunosuppressive therapy, and long-term outcome.Techniques in coloproctology · 2024Article
- Current Status and Surgical Technique for Restorative Proctocolectomy with Ileal Pouch Anal AnastomosisBalkan medical journal · 2023Review
- Routine placement of abdominal drainage in pouch surgery does not impact on surgical outcomes.Updates in surgery · 2023Article
- Laparoscopic surgery contributes to a decrease in short-term complications in surgical ulcerative colitis patients during 2008-2017: a multicenter retrospective study in China.Intestinal research · 2023Article
- Minimally Invasive and Robotic Surgery for Ulcerative Colitis.Clinics in colon and rectal surgery · 2022Review
- Staging Pouch Surgery in Ulcerative Colitis in the Biological Era.Clinics in colon and rectal surgery · 2022Review
- Quality of Life in Inflammatory Bowel Diseases (IBDs) Patients after Surgery.Reviews on recent clinical trials · 2022Review
- Ileal Pouch-anal Anastomosis Complications and Pouch Failure: A systematic review and meta-analysis.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2021Article
- Restorative surgery for ulcerative colitis in the elderly: an analysis of ileal pouch-anal anastomosis procedures from the American College of Surgeons National Surgical Quality Improvement Program.Techniques in coloproctology · 2020Article
- Fecal continence outcomes are associated with the type, height, and stage procedure of ileal pouch-anal anastomosis.International journal of colorectal disease · 2020Article
- Modern surgery for ulcerative colitis.Updates in surgery · 2020Review
- Bowel Function After J-Pouch May Be More Complex Than Previously Appreciated: A Comprehensive Analysis to Highlight Existing Knowledge Gaps.Diseases of the colon and rectum · 2020Article
- Management of Acute Severe Colitis in the Era of Biologicals and Small Molecules.Journal of clinical medicine · 2019Review
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
purposeMany surgeons assume 3-stage ileal pouch-anal anastomosis (IPAA) is safer than 2-stage IPAA in patients with active ulcerative colitis (UC), although recent data suggest outcomes are comparable. This study aimed to compare perioperative complications, late complications, and functional outcomes after 2- versus 3-stage IPAA in patients with active UC.
methodsA retrospective review was conducted of patients who underwent 2- or 3-stage IPAA for active UC from 2000 to 2015 in a high-volume institution. Patients completed quality-of-life surveys 6 months following ileostomy reversal. Perioperative and late complications were recorded. Outcomes were compared with the Fisher exact test, and multivariable logistic regression was used to adjust for potential confounders.
resultsWe identified 212 patients who underwent 2- or 3-stage IPAA for active UC, of whom 157 patients (74.1%) underwent 2-stage procedures and 55 (25.9%) underwent 3-stage procedures. More patients undergoing 2-stage procedures were taking immunomodulators preoperatively (46.3% vs. 23.1%, p = 0.01), but there was no difference in use of steroids (p = 0.09) or biologic agents (p = 0.85). Three-stage procedures were more likely to be urgent (78.6% vs. 30.2%, p < 0.001). There were no differences in perioperative complications (p = 0.50), anastomotic leak (p = 0.94), pouchitis (p = 0.45), pouch failure (p = 0.46), perceived quality of life (p = 0.68), number of bowel movements per day (p = 0.27), or sexual satisfaction (p = 0.21) between the 2- and 3-stage groups.
conclusionsPatients undergoing 2-stage compared to 3-stage IPAA for active ulcerative colitis have comparable outcomes and quality of life following ileostomy reversal. Two-stage IPAA appears to be safe and appropriate, even in high-risk patients.
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