Details

Autor(en) / Beteiligte

• Barnes, Edward L
• Esckilsen, Scott
• Ashburn, Jean
• Barto, Amy
• Bloomfeld, Richard
• Cairns, Ashley
• Mehta, Kurren
• Patel, Pooja
• Dziwis, Jennifer
• Dunn, Michael S
• Rahbar, Reza
• Sadiq, Timothy S
• Hanson, John S
• Herfarth, Hans H

Titel

Extensive Colitis and Smoking Are Associated With Postoperative Complications Within 30 Days of Ileal Pouch–Anal Anastomosis

Ist Teil von

• Inflammatory bowel diseases, 2024-08, Vol.30 (8), p.1326-1333

Erscheinungsjahr

2024

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Abstract Background Our understanding of outcomes after proctocolectomy with ileal pouch–anal anastomosis (IPAA) for ulcerative colitis (UC) is largely based on analyses of selected populations. We created a state-level registry to evaluate the epidemiology of IPAA surgery and pouch-related outcomes across the major healthcare systems performing these surgeries in our state. Methods We created a retrospective cohort of all patients undergoing restorative proctocolectomy with IPAA for UC at 1 of 4 centers between January 1, 2018, and December 31, 2020. The primary outcomes of this study were the rate of complications and all-cause readmissions within the first 30 days of the final stage of IPAA surgery. Results During the study period, 177 patients underwent IPAA surgery with 66 (37%) experiencing a complication within 30 days. After adjusting for the number of stages in IPAA surgery, patients with extensive UC (odds ratio, 3.61; 95% confidence interval, 1.39-9.33) and current or former smokers (odds ratio, 2.98; 95% confidence interval, 1.38-6.45) were more likely to experience a complication. Among all patients, 57 (32%) required readmission within 30 days. The most common reasons for readmission were ileus/small bowel obstruction (22%), peripouch abscess (19%), and dehydration (16%). Conclusion In this first state-level examination of the epidemiology of IPAA for UC, we demonstrated that the complication rate after IPAA for UC was 37%, with one-third of patients being readmitted within 30 days. Extensive disease at the time of colectomy appears to be an indicator of more severe disease and may portend a worse prognosis after IPAA.