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Survival of ileal pouch anal anastomosis constructed after colectomy or secondary to a previous ileorectal anastomosis in ulcerative colitis patients: a population-based cohort study
Ryhov County Hospital, Sweden; Oxford University Hospital NHS Fdn Trust, England.
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Suez Canal University, Egypt.
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Ryhov County Hospital, Sweden.
2017 (English)In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 52, no 5, 531-535 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: Ileorectal anastomosis (IRA) affects bowel function, sexual function and reproduction less negatively than ileal pouch anal anastomosis (IPAA), the standard reconstruction after colectomy for ulcerative colitis (UC). In younger UC patients, IRA may have a role postponing pelvic surgery and IPAA. The aim of the present study was to investigate the survival of IPAA secondary to IRA compared to IPAA as primary reconstruction, as this has not previously been studied in UC. Patients and methods: All patients with UC diagnosis between 1960 and 2010 in Sweden were identified from the National Patient Registry. From this cohort, colectomized patients reconstructed with primary IPAA and patients reconstructed with IPAA secondary to IRA were identified. The survival of the IPAA was followed up until pouch failure, defined as pouchectomy and ileostomy or a diverting ileostomy alone. Results: Out of 63,796 patients, 1796 were reconstructed with IPAA, either primarily (n=1720) or secondary to a previous IRA (n=76). There were no demographic differences between the groups, including length of follow-up (median 12.6 (IQR 6.7-16.6) years and 10.0 (IQR 3.5-15.9) years, respectively). Failure of the IPAA occurred in 103 (6.0%) patients with primary and in 6 (8%) patients after secondary IPAA (P=0.38 log-rank). The 10-year pouch survival was 94% (95% CI 93-96) for primary IPAA and 92% (81-97) for secondary. Conclusions: Patients choosing IRA as primary reconstruction do not have an increased risk of failure of a later secondary IPAA in comparison with patients with primary IPAA.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD , 2017. Vol. 52, no 5, 531-535 p.
Keyword [en]
Ulcerative colitis; inflammatory bowel disease; ileal pouch anal anastomosis; ileoanal pouches; ileoanal reservoir; pelvic pouches; ileorectal anastomosis; restorative proctocolectomy; pouch failure; pouch survival
National Category
Gastroenterology and Hepatology
Identifiers
URN: urn:nbn:se:liu:diva-136233DOI: 10.1080/00365521.2016.1278457ISI: 000395746800006PubMedID: 28102092OAI: oai:DiVA.org:liu-136233DiVA: diva2:1086220
Note

Funding Agencies|Bengt Ihres Fund; Medical Research Council of Southeast Sweden; Futurum - Academy for Health and Care; Region Jonkoping County, Sweden

Available from: 2017-03-31 Created: 2017-03-31 Last updated: 2017-04-24

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The full text will be freely available from 2018-01-19 11:17
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Abdalla, MaieMyrelid, PärAndersson, Roland
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Division of Clinical SciencesFaculty of Medicine and Health SciencesDepartment of Surgery in Linköping
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CiteExportLink to record
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