Abstract
Background
Restorative proctocolectomy with ileal-pouch anal-anastomosis (IPAA) is the operation
of choice for patients with ulcerative colitis (UC) or with inflammatory bowel diseases
unclassified (IBDU).
Aims
to assess the incidence and risk factors of chronic pouchitis (CP) and Crohn's disease
of the pouch (CDP) in patients with UC or IBDU.
Methods
We conducted a retrospective study. We included consecutive patients who underwent
IPAA between 2011 and 2019. The main outcome was the occurrence of CP or CDP. We looked
for risk factors with multivariable and a least absolute shrinkage and selection operator
(LASSO) Cox models.
Results
247 patients were included. The 5-year cumulative incidence of CP or CDP was 35.3%
(95%CI: 26.2–43.2). In multivariable analysis, diagnosis of IBDU, age less than 35
years at surgery and extra-intestinal manifestations other than articular and primary
sclerosing cholangitis were associated with higher incidence. The LASSO analysis identified
these three prognostic factors and articular manifestations. In patients with two
or more prognostic factors, 5-year cumulative incidence, was 65.2% (95%CI: 41.8–79.2).
Conclusions
Five years after IPAA, approximately one-third of patients had either CP or CDP. Risk
factors were IBDU, an age less than 35 years at surgery, articular manifestations
and other extra-intestinal manifestations.
Keywords
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Article info
Publication history
Published online: April 27, 2021
Accepted:
March 24,
2021
Received in revised form:
March 7,
2021
Received:
January 24,
2021
Identification
Copyright
© 2021 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
