The extent of inflammation is a predictor for pouch‐related complications in ileal pouches in patients with ulcerative or indeterminate colitis. (August 2014)

• Record Type: Journal Article
• Authors: Tan, K.‐K.; Ravindran, P.; Young, C. J.; Solomon, M. J.
• Is Part Of: Colorectal disease. Volume 16:Number 8(2014)
• Page Start: 620
• Page End: 625
• Publication Date: 2014-08
• Subjects: Colon (Anatomy) -- Diseases -- Periodicals; Rectum -- Diseases -- Periodicals; 616.34
• DOI: 10.1111/codi.12614
• Languages: English
• ISSNs: 1462-8910

Abstract

<abstract abstract-type="main" id="codi12614-abs-0001"> <title>Abstract</title> <sec id="codi12614-sec-0001" sec-type="section"> <title>Aim</title> <p>Limited data are available on the relationship between the histological features of the resected specimens in patients with ulcerative colitis (UC) or indeterminate colitis (IC) and the outcome of restorative proctocolectomy. The aim of our study was to determine if the histological features of the resected specimen in patients with UC and IC can predict ileal‐pouch‐related outcome.</p> </sec> <sec id="codi12614-sec-0002" sec-type="section"> <title>Method</title> <p>A review of all patients who had a restorative proctocolectomy created following completion proctectomy or proctocolectomy for UC and IC was performed.</p> </sec> <sec id="codi12614-sec-0003" sec-type="section"> <title>Results</title> <p>Between 1992 and 2011, 142 patients (132 with UC and 10 with IC) were reviewed. After a median follow‐up of 36 (3–149) months, 51 (35.9%) developed a pouch‐related complication. Forty‐two (29.7%) developed pouchitis while three (2.1%) developed a pouch‐cutaneous fistula. Four (2.8%) had pouch failure, while stricture of the anastomosis was seen in three (2.1%) patients. The presence of extension of the inflammation into the muscularis propria of the resected specimen was associated with an increased risk of pouch‐related complications (<italic>P = </italic>0.01). The presence of submucosal oedema was also a significant risk factor (<italic>P</italic> = 0.03).</p> </sec> <sec id="codi12614-sec-0004" sec-type="section"> <title>Conclusion</title> <p>The extension of inflammation into the muscularis propria appears to predict pouch‐related complications following restorative proctocolectomy for UC or IC.</p> </sec> </abstract>