Article
Gastroenterology & Hepatology
Mohammed Deputy, Jonathan Segal, Lillian Reza, Guy Worley, Samuel Costello, Elaine Burns, Omar Faiz, Susan Clark, Ailsa Hart
Summary: The management of the pouch behaving badly requires a careful clinical assessment to identify potential underlying pathologies. The patient may present with a variety of symptoms, necessitating a thorough examination and specialist investigation. Understanding the specific causes of this clinical scenario is essential for effective treatment and improvement of quality of life.
COLORECTAL DISEASE
(2021)
Article
Gastroenterology & Hepatology
Maia Kayal, Ryan C. Ungaro, Alexa Riggs, Kanika Kamal, Manasi Agrawal, Shirley Cohen-Mekelburg, Jordan Axelrad, Adam Faye, Ellen Scherl, Garrett Lawlor, Keith Sultan, Dana Lukin, Marla C. Dubinsky, Jean Frederic Colombel
Summary: Patients with IPAA have higher disability scores than those with UC, even after adjusting for disease activity. Female sex and public insurance are predictive factors for significant disability in patients with IPAA.
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
(2022)
Article
Surgery
Marianna Maspero, Olga Lavryk, Jeremy Lipman, Michael Valente, Hermann Kessler, Stefan Holubar, Scott R. Steele, Tracy Hull
Summary: Outcomes after redo ileal pouch-anal anastomosis were comparable between patients with early and late sepsis-related index pouch failure, with acceptable rates of long-term pouch survival and good quality of life.
Review
Oncology
Guillaume Le Cosquer, Etienne Buscail, Cyrielle Gilletta, Celine Deraison, Jean-Pierre Duffas, Barbara Bournet, Geraud Tuyeras, Nathalie Vergnolle, Louis Buscail
Summary: Proctocolectomy with ileal pouch-anal anastomosis is the recommended surgical intervention for ulcerative colitis and familial adenomatous polyposis. However, there is a risk of high-grade dysplasia and cancer in the anal transitional zone and ileal pouch after 20 years, with estimated rates of 2% to 4.5% and 3% to 10% in ulcerative colitis and familial polyposis, respectively. Risk factors for ulcerative colitis include pre-operative dysplasia or cancer, disease duration > 10 years, and severe villous atrophy. For familial polyposis, risk factors include > 1000 pre-operative polyps, stapled anastomosis, and duration of follow-up. While anal transitional zone and ileal pouch cancers rarely occur after proctectomy, the high mortality rate associated with this complication necessitates close endoscopic monitoring.
Article
Gastroenterology & Hepatology
Clement Bresteau, Aurelien Amiot, Julien Kirchgesner, Nicola De'Angelis, Jeremie H. Lefevre, Yoram Bouhnik, Yves Panis, Laurent Beaugerie, Matthieu Allez, Antoine Brouquet, Franck Carbonnel, Antoine Meyer
Summary: A retrospective study of 247 patients who underwent IPAA surgery between 2011 and 2019 found a 5-year cumulative incidence of CP or CDP of 35.3%. Risk factors included IBDU diagnosis, age less than 35 at surgery, articular manifestations, and other extra-intestinal manifestations.
DIGESTIVE AND LIVER DISEASE
(2021)
Article
Gastroenterology & Hepatology
Yoshiki Okita, Masaki Ohi, Takahito Kitajima, Tadanobu Shimura, Akira Yamamoto, Hiroyuki Fujikawa, Yoshinaga Okugawa, Kohei Matsushita, Yuhki Koike, Mikihiro Inoue, Keiichi Uchida, Yuji Toiyama
Summary: This study identified early onset and severe disease activity as independent predictive factors for chronic pouchitis in patients with ulcerative colitis. Early treatment decisions based on evaluation of these factors can help alleviate chronic pouchitis.
JOURNAL OF GASTROINTESTINAL SURGERY
(2021)
Article
Gastroenterology & Hepatology
C. Seifarth, N. Slavova, C. Degro, K. S. Lehmann, M. E. Kreis, B. Weixler
Summary: This study evaluated the use of sacral nerve stimulation (SNS) in patients with high stool frequency or fecal incontinence after proctocolectomy with IPAA. The results showed that SNS improved symptoms in over two-thirds of patients, suggesting its feasibility as a therapeutic option in this patient population.
INTERNATIONAL JOURNAL OF COLORECTAL DISEASE
(2021)
Article
Surgery
Hordur Mar Kolbeinsson, Tyler Wall, Aqieda Bayat, Martin Luchtefeld, James W. Ogilvie
Summary: The study found that the risk of Crohn's disease and chronic pouchitis is higher in patients undergoing IPAA surgery for ulcerative colitis, significantly increasing the likelihood of pouch failure.
AMERICAN JOURNAL OF SURGERY
(2022)
Review
Gastroenterology & Hepatology
Ravi P. Kiran, Gursimran S. Kochhar, Revital Kariv, Douglas K. Rex, Akira Sugita, David T. Rubin, Udayakumar Navaneethan, Tracy L. Hull, Huaibin Mabel Ko, Xiuli Liu, Lisa A. Kachnic, Scott Strong, Marietta Iacucci, Willem Bemelman, Philip Fleshner, Rachael A. Safyan, Paulo G. Kotze, Andre D'Hoore, Omar Faiz, Simon Lo, Jean H. Ashburn, Antonino Spinelli, Charles N. Bernstein, Sunanda V. Kane, Raymond K. Cross, Jason Schairer, James T. McCormick, Francis A. Farraye, Shannon Chang, Ellen J. Scherl, David A. Schwartz, David H. Bruining, Jessica Philpott, Stuart Bentley-Hibbert, Dino Tarabar, Sandra El-Hachem, William J. Sandborn, Mark S. Silverberg, Darrell S. Pardi, James M. Church, Bo Shen
Summary: Surveillance pouchoscopy is recommended to monitor the risk of neoplasia in patients after restorative proctocolectomy. Treatment modalities depend on the characteristics and location of neoplastic lesions, as well as the patients' risk factors and medical expertise.
LANCET GASTROENTEROLOGY & HEPATOLOGY
(2022)
Article
Gastroenterology & Hepatology
Amy L. Lightner, Sarah Vogler, John McMichael, Xue Jia, Miguel Regueiro, Taha Qazi, Scott R. Steele
Summary: While UC patients were more likely to have neoplasia detected during colonoscopy, the rates of progression from LGD and HGD to adenocarcinoma were equivalent in UC and CD, suggesting consistent endoscopic surveillance strategies for all IBD patients.
JOURNAL OF CROHNS & COLITIS
(2021)
Article
Gastroenterology & Hepatology
Joseph Runde, Amarachi Erondu, Shintaro Akiyama, Cindy Traboulsi, Victoria Rai, Laura R. Glick, Yangtian Yi, Jacob E. Ollech, Russell D. Cohen, Kinga B. Skowron, Roger D. Hurst, Konstatin Umanskiy, Benjamin D. Shogan, Neil H. Hyman, Michele A. Rubin, Sushila R. Dalal, Atsushi Sakuraba, Joel Pekow, Eugene B. Chang, David T. Rubin
Summary: A study compared the pouch survival rate between pediatric and adult patients who underwent IPAA surgery, finding that pediatric patients had lower pouch survival rates after anti-TNF therapy, with a significant decrease in survival rate for children operated on in the last 10 years.
INFLAMMATORY BOWEL DISEASES
(2022)
Article
Medicine, General & Internal
Rui-Bin Li, Chun-Qiang Li, Shi-Yao Zhang, Kai-Yu Li, Zhi-Cheng Zhao, Gang Liu
Summary: This study suggests that fecal calprotectin (FC) concentration can be used as a clinical indicator for diagnosing and assessing the risk of pouchitis in patients with ulcerative colitis. Regular FC measurement is recommended for monitoring pouchitis. An FC concentration in the range of 143.25-579.60μg/g indicates a high risk for pouchitis, requiring further examination and preventive treatment.
ANNALS OF MEDICINE
(2023)
Article
Gastroenterology & Hepatology
Maud A. Reijntjes, Eva K. Bocharewicz, Roel Hompes, Christianne J. Buskens, Willem A. Bemelman
Summary: This study compared chronic pouch failure rates and causes of different pouch designs in patients who underwent ileo-pouch anal anastomosis surgery. It was found that patients with S/SP pouches had a significantly higher incidence of pouch failure due to emptying problems compared to patients with J/B pouches.
INTERNATIONAL JOURNAL OF COLORECTAL DISEASE
(2022)
Article
Gastroenterology & Hepatology
Anam Rizvi, Parth Trivedi, Ariel Bar-Mashiah, Michael Plietz, Sergey Khaitov, Patricia Sylla, Alexander Greenstein, Marla C. Dubinsky, Maia Kayal
Summary: In a retrospective study of 412 ulcerative colitis patients who underwent total proctocolectomy with ileal pouch anal anastomosis and subsequent pouchoscopy, it was found that low 25-hydroxyvitamin D levels were common and not significantly associated with age, sex, ethnicity, or medication use before the surgery.
INFLAMMATORY BOWEL DISEASES
(2022)
Article
Surgery
Weimin Xu, Wenbo Tang, Wenjun Ding, Hang Hu, Wenhao Chen, Qun Qian, Long Cui, Zhao Ding, Peng Du
Summary: By analyzing the predictive value of preoperative endoscopic activity in UC patients undergoing IPAA, it was found that UCEIS >= 7 is an independent risk factor for pouchitis after IPAA, with better performance in predicting pouchitis.
FRONTIERS IN SURGERY
(2021)