ArticleColorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland2023
Predictors of pouch failure: A tertiary care inflammatory bowel disease centre experience.
Article in Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 15 citations in OpenAlex.
- Review
- Predictors of ileal pouch-anal anastomosis failure in ulcerative colitis: a European tertiary referral center experience.Techniques in coloproctology · 2026Article
- Article
- Endoscopic Evaluation and Management of Diversion Pouchitis and Strictures: In Comparison With Strictures in Nondiverted Pouches.Gastro hep advances · 2026Article
- Biological therapies for inflammatory pouch disorders: insights and outcomes from the RESERVO study of GETECCU.Therapeutic advances in gastroenterology · 2026Article
- Incidence and Long-Term Outcomes of Pouchitis in Ulcerative Colitis Patients.United European gastroenterology journal · 2025Article
- Comparative analysis of robotic, laparoscopic, and open ileal pouch-anal anastomosis outcomes: retrospective cohort study.BJS open · 2025Article
- Medical, Endoscopic, and Surgical Treatments for Rectal Cuffitis in IBD Patients with an Ileal Pouch-Anal Anastomosis: A Narrative Review.Digestive diseases and sciences · 2025Review
- Crohn's-like Ileal Pouch Illness and Ileal Pouch Salvage Strategies.Clinics in colon and rectal surgery · 2025Review
- Extensive Disease and Exposure to Multiple Biologics Precolectomy Is Associated with Endoscopic Cuffitis Post-Ileal Pouch-Anal Anastomosis in Patients With Ulcerative Colitis.Inflammatory bowel diseases · 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
- Creation of an institutional preoperative checklist to support clinical risk assessment in patients with ulcerative colitis (UC) considering ileoanal pouch surgery.Frontline gastroenterology · 2024Article
- Association of colonic metaplasia of goblet cells and endoscopic phenotypes of the J pouch in patients with ulcerative colitis: a retrospective pilot study.Intestinal research · 2024Article
- Ubiquitous Colonic Ileal Metaplasia Consistent with the Diagnosis of Crohn's Colitis among Indeterminate Colitis Cohorts.Medical research archives · 2023Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
aimRates of pouch failure after total proctocolectomy with ileal pouch-anal anastomosis (IPAA) range from 5% to 18%. There is little consistency across studies regarding the factors associated with failure, and most include patients who underwent IPAA in the pre-biologic era. Our aim was to analyse a cohort of patients who underwent IPAA in the biologic era at a large-volume inflammatory bowel disease institution to better determine preoperative, perioperative and postoperative factors associated with pouch failure.
methodsA retrospective cohort analysis was performed with data from an institutional review board approved prospective database with ulcerative colitis or unclassified inflammatory bowel disease patients who underwent total proctocolectomy with IPAA at Mount Sinai Hospital between 2008 and 2017. Preoperative, perioperative and postoperative data were collected and univariate and multivariate analyses were performed to identify factors associated with increased risk of pouch failure.
resultsOut of 664 patients included in the study, pouch failure occurred in 41 (6.2%) patients, a median of 23.3 months after final surgical stage. Of these, 17 (41.4%) underwent pouch excision and 24 (58.5%) had diverting ileostomies. The most common indications for pouch failure were Crohn's disease like pouch inflammation (CDLPI) (n = 17, 41.5%), chronic pouchitis (n = 6, 14.6%), chronic cuffitis (n = 5, 12.2%) and anastomotic stricture (n = 4, 9.8%). On multivariate analysis, pre-colectomy biologic use (hazard ratio [HR] 2.25, 95% CI 1.09-4.67), CDLPI (HR 3.18, 95% CI 1.49-6.76) and pouch revision (HR 2.59, 95% CI 1.26-5.32) were significantly associated with pouch failure.
conclusionsPouch failure was significantly associated with CDLPI, preoperative biologic use and pouch revision; however, reassuringly it was not associated with postoperative complications.
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