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Background <p>Proctocolectomy with ileal pouch–anal anastomosis (IPAA) is the preferred surgical intervention for patients with refractory ulcerative colitis (UC) and can be performed in different stages. The present study aimed to compare quality of life, pouch function, stoma-related complications, and postoperative reoperation rates between two- and three-stage restorative proctocolectomy with IPAA for UC.</p> Methods <p>Patients who underwent either two- or three-stage restorative proctocolectomy with IPAA for UC between 2019 and 2024 at the Shahid Faghihi and Mother and Child Hospitals in Shiraz, Iran, were included in this study. Data regarding the type of surgery and the need for reoperation due to complications were collected by reviewing the operative notes. Information on stoma-related complications, quality of life, and current pouch function was obtained via direct contact with patients. Subsequently, data were compared between the two surgical approaches using SPSS version&#xa0;25 (IBM Corp., Armonk, NY, USA).</p> Results <p>A&#xa0;total of 86&#xa0;patients were included in this study (53.5% with two-stage IPAA and 46.5% with three-stage IPAA). Patients who underwent three-stage IPAA experienced significantly longer hospital stays (<i>p</i>-value &lt; 0.001) and had higher rates of wound complications around the stoma (<i>p</i>-value = 0.026) and infections (<i>p</i>-value = 0.022) than those who underwent two-stage IPAA. No significant differences were observed in pouch dysfunction or quality of life between the two groups.</p> Conclusion <p>The two-stage IPAA procedure may have advantages in terms of reducing hospital stays and having fewer stoma-related complications. However, both surgical approaches demonstrate comparable outcomes concerning pouch function, quality of life, and reoperation rates.</p>

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Outcomes of two- and three-stage restorative proctocolectomy with ileal pouch–anal anastomosis for ulcerative colitis

  • 期刊论文

  • 发表日期：

    2025年8月26日

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  • Seyed Vahid Hosseini,
  • Ahmed Mohammed Ali Hussein Alhurry,
  • Hamid Pourvali,
  • Vahid Asgharzadeh,
  • Zahra Ghanbarzadegan,
  • Zahra Zabangirfard,
  • Sara Shojaei-Zarghani

摘要

Background

Proctocolectomy with ileal pouch–anal anastomosis (IPAA) is the preferred surgical intervention for patients with refractory ulcerative colitis (UC) and can be performed in different stages. The present study aimed to compare quality of life, pouch function, stoma-related complications, and postoperative reoperation rates between two- and three-stage restorative proctocolectomy with IPAA for UC.

Methods

Patients who underwent either two- or three-stage restorative proctocolectomy with IPAA for UC between 2019 and 2024 at the Shahid Faghihi and Mother and Child Hospitals in Shiraz, Iran, were included in this study. Data regarding the type of surgery and the need for reoperation due to complications were collected by reviewing the operative notes. Information on stoma-related complications, quality of life, and current pouch function was obtained via direct contact with patients. Subsequently, data were compared between the two surgical approaches using SPSS version 25 (IBM Corp., Armonk, NY, USA).

Results

A total of 86 patients were included in this study (53.5% with two-stage IPAA and 46.5% with three-stage IPAA). Patients who underwent three-stage IPAA experienced significantly longer hospital stays (p-value < 0.001) and had higher rates of wound complications around the stoma (p-value = 0.026) and infections (p-value = 0.022) than those who underwent two-stage IPAA. No significant differences were observed in pouch dysfunction or quality of life between the two groups.

Conclusion

The two-stage IPAA procedure may have advantages in terms of reducing hospital stays and having fewer stoma-related complications. However, both surgical approaches demonstrate comparable outcomes concerning pouch function, quality of life, and reoperation rates.