The Cleveland Classification of Ileal Pouch Disorders

Crohn's-like Ileal Pouch Illness and Ileal Pouch Salvage Strategies

“…However, certain factors such as a history of primary sclerosing cholangitis or chronic pouchitis increase this risk. 45 46 Given this, a pouchoscopy should be performed annually in patients with CLIPI for both disease activity assessment and neoplasia surveillance. 46 Consideration should be made to note the extent of disease and obtain biopsies of the prepouch ileum, pouch body, and cuff (if present).…”

“…45 46 Given this, a pouchoscopy should be performed annually in patients with CLIPI for both disease activity assessment and neoplasia surveillance. 46 Consideration should be made to note the extent of disease and obtain biopsies of the prepouch ileum, pouch body, and cuff (if present). Dependent on the extent of involvement of the prepouch ileum and the presence of strictures or fistulae, surveillance may also include imaging of the abdomen and pelvis annually.…”

Cancer in the Anal Transition Zone and Ileoanal Pouch following Surgery for Ulcerative Colitis

“…Research literature is primarily composed of case reports, systematic reviews, and a few meta-analyses, with a more recent consortium of experts publishing guidelines on management of pouch neoplasia with hopes of standardizing care and identifying ideal surgical and surveillance strategies for these challenging patients. 19…”

“…30 Recently, the International Ileal Pouch Consortium was created to assimilate the available data on the topic and put forth its expert recommendation for endoscopic surveillance based on individual risk stratification. 19 The group recommended annual pouchoscopy in patients undergoing RPC/IPAA for existing dysplasia or malignancy. Other high-risk patients with PSC, refractory pouchitis or cuffitis, UC of more than 8 years, Crohn's disease of the pouch, or a family history of colorectal cancer are encouraged to undergo pouchoscopy at 1- to 3-year intervals, as summarized in Fig.…”