ArticleInternational journal of colorectal disease2023
Comparing continent ileostomy (CI) conversion to repair/redo IPAA: favorable outcomes.
Article in International journal of colorectal disease, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 3 citations in OpenAlex.
- Surgical interventions in inflammatory bowel disease: Indications, techniques, outcomes, and future directions.World journal of gastrointestinal pharmacology and therapeutics · 2026Article
- Conversion of Barnett continent reservoir to Kock reservoir: A 30-year retrospective study on surgical outcomes and long-term follow-up.Techniques in coloproctology · 2026Article
- Diverting ileostomy for treatment of ileoanal pouch dysfunction: a technical note.International journal of colorectal disease · 2024Article
- Salvage surgery for pouch-related complication after ileal pouch-anal anastomosis: a report of two cases.Surgical case reports · 2024Article
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Authors and funding
4 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThis study aims to compare the outcomes of repair/redo ileal pouch-anal anastomosis (repair/redo-IPAA) with the conversion of IPAA to continent ileostomy (CI) in an effort to prevent the need for a permanent ileostomy (IS) following IPAA failure.
methodsThis research involved a retrospective analysis of surgical records, employing descriptive statistics and Kaplan-Meier survival analysis.
resultsAmong 57 patients with an IPAA, up to three revisions were necessary due to complications or complete failure. Ultimately, repair/redo-IPAA preserved the IPAA in 14 patients (24.6%), conversion to CI salvaged the pouch in 21 patients (36.8%), and IS was unavoidable in 22 patients (38.6%). The cumulative probability of requiring conversion surgery was calculated to be 54.0% at 20 years, thereby reducing the cumulative risk of IS to 32.3%. The 20-year cumulative probability of pouch salvage by repair/redo IPAA was only 21.9%. However, this rate increased to 67.7% when conversion procedures were considered. Following repair/redo-IPAA, only 8.3% of patients reported evacuation frequencies of ≤ 4 during the day, and 16.7% were evacuation-free at night. In contrast, after conversion to CI, 98.0% of patients reported a maximum of four evacuations in a 24-h period. After undergoing repair/redo IPAA, between half and two-thirds of patients reported experiencing incontinence or soiling, while complete continence was achieved in all patients following conversion to CI. Notably, the majority of patients expressed overall satisfaction with their respective procedures. A positive correlation was identified between very high subjective satisfaction and positive objective surgical outcomes exclusively in patients who underwent conversion to CI.
conclusionWhen complications or failure of IPAA occur, conversion to CI emerges as a highly viable alternative to repair/redo IPAA. This conclusion is supported by the observation that patient satisfaction appears to be closely tied to stable surgical outcomes. To reinforce these findings, further prospective studies are warranted.
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