ArticleAnnals of surgery open : perspectives of surgical history, education, and clinical approaches2025
One-year stoma-free survival of ileoanal pouches for UC in European centers: The MIRACLE project.
Article in Annals of surgery open : perspectives of surgical history, education, and clinical approaches, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective and Background: Restorative proctocolectomy with ileal pouch-anal anastomosis is the standard surgical procedure for patients with refractory ulcerative colitis. The aim of this study was to evaluate intermediate-term stoma-free rates after ileoanal pouch surgery and current practice in various European centers. Methods: In this multicenter retrospective cohort study, we included patients ≥18 years with ulcerative colitis or unclassified inflammatory bowel disease undergoing primary ileoanal pouch construction between 2016 and 2021 in 4 high-volume (>10 pouch procedures annually) and 2 low-volume European centers. The primary outcome was an intermediate-term stoma-free rate (absence of ileostomy > 1-year postpouch). Secondary outcomes included perioperative practice, predictive factors for intermediate-term stoma-free status, and anastomotic leakage management. Results: In total, 411 patients were included [43% female, median age 40.0 years (IQR, 29.0-52.0)]. Intermediate-term stoma-free rate was 92.2% (378/410 patients), with a variance of 13.0% between centers ( Conclusions: This study showed that >90% of ileoanal pouch patients are stoma-free more than 1 year after surgery with substantial variance between centers. Centralization of pouch procedures, implementation of CRD proctectomy, and early diagnosis and treatment of anastomotic leakages could further improve results.
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