Predictors of Pouchitis after Ileal Pouch-Anal Anastomosis: A Retrospective Review

Hoda, Katherine M.; Collins, Judith; Knigge, Kandice L.; Deveney, Karen E.

doi:10.1007/s10350-008-9194-7

Cited by 94 publications

(49 citation statements)

References 15 publications

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“…Pouchitis occurs in up to 60 % of patients aft er a mean follow-up of 40 months ( 334,335 ) and occurs more frequently in patients with PSC, preoperative EIMs ( 336 -338 ), and in patients who had never smoked ( 339 ). Chronic pouchitis may be more likely to occur in those patients with early postoperative anastomotic complications ( 340 ).…”

Section: Recommendations For Surgerymentioning

confidence: 99%

Ulcerative Colitis Practice Guidelines in Adults: American College of Gastroenterology, Practice Parameters Committee

Kornbluth

Sachar

2010

American Journal of Gastroenterology

1,156

977

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Guidelines for clinical practice are aimed to indicate preferred approaches to medical problems as established by scientifi cally valid research. Double-blind placebo controlled studies are preferable, but compassionate-use reports and expert review articles are used in a thorough review of the literature conducted through Medline with the National Library of Medicine. When only data that will not withstand objective scrutiny are available, a recommendation is identifi ed as a consensus of experts. Guidelines are applicable to all physicians who address the subject regardless of specialty training or interests and are aimed to indicate the preferable but not necessarily the only acceptable approach to a specifi c problem. Guidelines are intended to be fl exible and must be distinguished from standards of care, which are infl exible and rarely violated. Given the wide range of specifi cs in any healthcare problem, the physician must always choose the course best suited to the individual patient and the variables in existence at the moment of decision. Guidelines are developed under the auspices of the American College of Gastroenterology and its Practice Parameters Committee and approved by the board of trustees. Each has been intensely reviewed and revised by the Committee, other experts in the fi eld, physicians who will use them, and specialists in the science of decision analysis. The recommendations of each guideline are therefore considered valid at the time of composition based on the data available. New developments in medical research and practice pertinent to each guideline will be reviewed at a time established and indicated at publication to assure continued validity. The recommendations made are based on the level of evidence found. Grade A recommendations imply that there is consistent level 1 evidence (randomized controlled trials), grade B indicates that the evidence would be level 2 or 3, which are cohort studies or case -control studies. Grade C recommendations are based on level 4 studies, meaning case series or poor-quality cohort studies, and grade D recommendations are based on level 5 evidence, meaning expert opinion.

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Section: Recommendations For Surgerymentioning

confidence: 99%

Ulcerative Colitis Practice Guidelines in Adults: American College of Gastroenterology, Practice Parameters Committee

Kornbluth

Sachar

2010

American Journal of Gastroenterology

1,156

977

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“…Genetic polymorphisms, extraintestinal manifestations, the presence of serum perinuclear antineutrophil cytoplasmic antibodies, backwash ileitis, thrombocytosis, non-smoking behaviour, extensive UC and the use of NSAIDs are some of the previously identified risk factors for pouchitis [8]. A retrospective review by Hoda et al [9] found that patients who did not undergo diverting ileostomy at the time of the IPAA and those with postoperative complications were more likely to develop chronic pouchitis, whereas primary sclerosing cholangitis and extraintestinal manifestations -known predictors for acute pouchitis -did not trend toward a higher likelihood of developing chronic pouchitis.…”

Section: Discussionmentioning

confidence: 99%

Management of Patients with Ulcerative Colitis after Proctocolectomy:Pouchitis is a Real Danger

Molnár

Farkas²,

Nagy³

et al. 2011

J Gastrointest Dig Syst

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Pouchitis develops in about 50% of the patients with ulcerative colitis (UC) undergoing colectomy. Aim:The aim of this study was to evaluate the frequency of pouchitis, to determine risk factors and to assess the efficacy of infliximab in refractory pouchitis.Patients and Methods: 76% of the 46 UC patients requiring colectomy underwent ileal pouch-anal anastomosis (IPAA) procedure. Demographic, clinical and therapeutic parameters were compared between patients who did and did not develop pouchitis and between those with pouchitis responding or being refractory to the conservative therapy.Results: 40% of the patients developed pouchitis. Six patients received infliximab therapy. Extraintestinal manifestation and non smoking was characteristic for refractory pouchitis.Discussion: Pouchitis developed in 40% of our patients undergoing IPAA. The development of pouchitis seems to be predisposed by frequent preoperative hospitalization. The earlier onset of pouchitis seems to be a prognostic factor for the unsuccessful conservative treatment and the need for biological therapy.

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“…Pouchitt, definert som økende avføringsfre-kvens, endret avføringskonsistens, blodig avføring og smerter av varighet i over to døgn, sammenholdt med funn ved reservoarskopi, ble sett hos 30 % av pasientene. I andre undersøkelser har det vaert pouchitt hos opptil 60 % av pasientene under en oppfølgingstid på opp mot 20 år (1,4,8,9). År-saken til at vi har hatt mindre pouchitt kan vaere kortere observasjonstid (median 109 md.).…”

Section: Diskusjonunclassified

“…Ut fra prospektive studier med lang observasjonstid (opp mot 20 år) er det også antydet en mulig tendens til dårligere funksjonelle resultater over tid, det gjelder da spesielt lekkasjeproblemer (5,16). Det samme er tilfellet for lokale komplikasjonerførst og fremst pouchitt, der man vet at forekomsten øker med økende observasjonstid (1,4,8,9,17). Når en pasient mister reservoaret etter lengre tid, skyldes det som oftest kronisk pouchitt (6).…”

Section: Diskusjonunclassified

Bekkenreservoarkirurgi

Stornes¹,

Skreden²,

Sollie³

et al. 2010

Tidsskriftet

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Predictors of Pouchitis after Ileal Pouch-Anal Anastomosis: A Retrospective Review

Cited by 94 publications

References 15 publications

Ulcerative Colitis Practice Guidelines in Adults: American College of Gastroenterology, Practice Parameters Committee

Ulcerative Colitis Practice Guidelines in Adults: American College of Gastroenterology, Practice Parameters Committee

Management of Patients with Ulcerative Colitis after Proctocolectomy:Pouchitis is a Real Danger

Bekkenreservoarkirurgi

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