Scholarlink

Purpose <p>Long-term data on the risk factors for fistulizing disease (FD) after ileal pouch-anal anastomosis (IPAA) for ulcerative colitis are limited. This study aimed to identify the predictors of FD after ileostomy closure and evaluate the impact of FD on pouch failure.</p> Methods <p>We reviewed 374 patients who underwent mucosal restorative proctocolectomy with handsewn IPAA between 2004 and 2022. Cox proportional hazards regression and log-rank tests were used to assess the FD-free survival and risk factors.</p> Results <p>After excluding 59 patients, 315 patients were analyzed. FD developed in 20 (6.3%) of these patients. Multivariate analysis showed that a monthly prednisolone (PSL) dose ≥ 450&#xa0;mg before IPAA and chronic pouchitis were independent risk factors for FD (odds ratio [OR] 2.96, 95% CI: 1.15–7.64, <i>p</i> = 0.025; OR 3.85, 95% CI: 1.52–9.78, <i>p</i> = 0.0045). Patients with PSL ≥ 450&#xa0;mg or chronic pouchitis had significantly poorer FD-free survival (<i>p</i> = 0.0004 and <i>p</i> = 0.0002, respectively). Pouch failure occurred more frequently in patients with FD than in those without FD (30.0% vs. 1.0%; <i>p</i> &lt; 0.0001).</p> Conclusions <p>High steroid exposure before IPAA and chronic pouchitis were significant predictors of FD, which strongly increased the risk of pouch failure.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Risk factors for fistulizing disease of the pouch after ileal pouch-Anal anastomosis for ulcerative colitis

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年2月9日

查看全文
  • Yoshiki Okita,
  • Yoshinaga Okugawa,
  • Hiroki Imaoka,
  • Tadanobu Shimura,
  • Takahito Kitajima,
  • Mikio Kawamura,
  • Hiromi Yasuda,
  • Yuhki Koike,
  • Shigeyuki Yoshiyama,
  • Masaki Ohi,
  • Yuji Toiyama

摘要

Purpose

Long-term data on the risk factors for fistulizing disease (FD) after ileal pouch-anal anastomosis (IPAA) for ulcerative colitis are limited. This study aimed to identify the predictors of FD after ileostomy closure and evaluate the impact of FD on pouch failure.

Methods

We reviewed 374 patients who underwent mucosal restorative proctocolectomy with handsewn IPAA between 2004 and 2022. Cox proportional hazards regression and log-rank tests were used to assess the FD-free survival and risk factors.

Results

After excluding 59 patients, 315 patients were analyzed. FD developed in 20 (6.3%) of these patients. Multivariate analysis showed that a monthly prednisolone (PSL) dose ≥ 450 mg before IPAA and chronic pouchitis were independent risk factors for FD (odds ratio [OR] 2.96, 95% CI: 1.15–7.64, p = 0.025; OR 3.85, 95% CI: 1.52–9.78, p = 0.0045). Patients with PSL ≥ 450 mg or chronic pouchitis had significantly poorer FD-free survival (p = 0.0004 and p = 0.0002, respectively). Pouch failure occurred more frequently in patients with FD than in those without FD (30.0% vs. 1.0%; p < 0.0001).

Conclusions

High steroid exposure before IPAA and chronic pouchitis were significant predictors of FD, which strongly increased the risk of pouch failure.