Clinical Discrimination of Chronic Pouchitis After Ileal Pouch-Anal Anastomosis in Patients with Ulcerative Colitis

被引:3
作者
Okita, Yoshiki [1 ,2 ]
Ohi, Masaki [1 ,2 ]
Kitajima, Takahito [1 ,2 ]
Shimura, Tadanobu [1 ,2 ]
Yamamoto, Akira [1 ,2 ]
Fujikawa, Hiroyuki [1 ,2 ]
Okugawa, Yoshinaga [1 ,2 ]
Matsushita, Kohei [1 ,2 ]
Koike, Yuhki [1 ,2 ]
Inoue, Mikihiro [1 ,2 ]
Uchida, Keiichi [1 ,2 ]
Toiyama, Yuji [1 ,2 ]
机构
[1] Mie Univ, Dept Gastrointestinal, Inst Life Sci, Grad Sch Med,Div Reparat Med, 2-174 Edobashi, Tsu, Mie 5148507, Japan
[2] Mie Univ, Dept Pediat Surg, Inst Life Sci, Grad Sch Med,Div Reparat Med, 2-174 Edobashi, Tsu, Mie 5148507, Japan
基金
日本学术振兴会;
关键词
Pouchitis; Ileal pouch-anal anastomosis; Ulcerative colitis; SEROLOGICAL MARKERS; RISK-FACTORS; DIAGNOSIS; MANAGEMENT; PROCTOCOLECTOMY; METAANALYSIS; DISEASE; IPAA;
D O I
10.1007/s11605-020-04842-w
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Purpose We aimed to identify predictive factors for the development of chronic pouchitis after ileal pouch-anal anastomosis in patients with ulcerative colitis. Methods Three hundred eighty-seven patients who underwent ileal pouch-anal anastomosis for diagnosis of ulcerative colitis from January 2002 to March 2019 were included in this retrospective analysis. Results Of 115 patients with pouchitis, 40 patients exhibited acute pouchitis, and 75 patients exhibited chronic pouchitis. Of 75 patients with chronic pouchitis, 11 patients were diagnosed with chronic antibiotic-refractory pouchitis. Multivariate analysis revealed that early pouchitis onset and modified Pouchitis Disease Activity Index score >= 7 were independent predictive factors for chronic pouchitis (p = 0.0004 and p = 0.029, respectively). Mean onset of pouchitis after intestinal continuity was significantly earlier in patients with chronic pouchitis than in patients with acute pouchitis (acute pouchitis vs. chronic pouchitis: 3.72 +/- 2.98 years vs. 1.85 +/- 2.40 years, p < 0.0001). Total modified Pouchitis Disease Activity Index score was significantly higher in patients with chronic pouchitis than in patients with acute pouchitis (acute pouchitis vs. chronic pouchitis: 5.9 +/- 1.2 vs. 6.9 +/- 1.6, p = 0.0020). Conclusion Patients with ulcerative colitis were more likely to develop chronic pouchitis if they exhibited early onset or severe disease activity at onset. Evaluation of both factors can aid in early treatment decisions to alleviate chronic pouchitis.
引用
收藏
页码:2047 / 2054
页数:8
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