Colonic Histological Criteria Predict Development of Pouchitis after Ileal Pouch: Anal Anastomosis for Patients with Ulcerative Colitis

Background/Aims: Pouchitis is one of the main complications after ileal pouch-anal anastomosis in patients with ulcerative colitis. The aim of this study was to determine whether the use of colonic histological criteria can predict the development of pouchitis. Methodology: We retrospectively reviewed 147 patients' clinical data and performed a histological evaluation of the resected total colon using Tanaka's criteria, which comprise the following 6 factors: ulceration (H-1), crypt abscesses (H-2), degree of mononuclear cell infiltration (MNCl) (H-3), segmental distribution of MNCl (H-4), eosinophil infiltration (H-5), and extent of disease of resected colon (H-6). Results: The development of pouchitis and chronic pouchitis within 3 years after restoration of gastrointestinal continuity was recognized in 52 (35.4%) and 26 (17.7%) of the 147 patients, respectively. Using various combinations of each score, the H-3 + H-4 - H-5 scores of patients with pouchitis or chronic pouchitis were significantly higher than those of patients without. A H-3 + H-4 - H-5 score of > 0.4 was a statistically significant risk factor for the development of both pouchitis and chronic pouchitis. Conclusions: The combination of the degree of MNCl, segmental distribution of MNCl, and eosinophil infiltration from histological criteria has utility in predicting the future development of pouchitis, especially chronic pouchitis. (C) 2017 S. Karger AG, Basel