Anatomic extent of colitis and disease severity are not predictors of pouchitis after restorative proctocolectomy for mucosal ulcerative colitis

被引：15
作者：
Sengul N. [1 ]
Wexner S.D. [1 ]
Hui S.M. [1 ]
Baig M.K. [1 ]
Thomas N. [2 ]
Connor J. [2 ]
Weiss E.G. [1 ]
Nogueras J.J. [1 ]
Berho M. [3 ]
机构：
[1] Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL
[2] Department of Biostatistics and Epidemiology, Cleveland Clinic Foundation, Cleveland, OH
[3] Department of Pathology, Cleveland Clinic Florida, Weston, FL 33331
来源：
Techniques in Coloproctology | 2006年 / 10卷 / 1期
关键词：
Ileoanal J pouch; Mucosal ulcerative colitis; Pouchitis; Restorative proctocolectomy;
D O I：
10.1007/s10151-006-0247-4
中图分类号：
学科分类号：
摘要：
Background: Pouchitis is a common complication following restorative proctocolectomy with ileal pouch anal anastomosis (RPC-IPAA) for mucosal ulcerative colitis (MUC). The aim of this study was to determine if perioperative anatomic extent and severity of disease are predictors of pouchitis. Methods: All consecutive patients who underwent RPC-IPAA for MUC between 1988 and 2002 were retrospectively studied. Pouchitis was classified as acute, recurrent or refractory. Colectomy specimen slides were histopathologically evaluated by a single blinded pathologist (MB), who assessed extent and severity of disease. Results: Of 112 patients assessed, 70 (62.5%) had some form of pouchitis at a median follow-up of 38 months (range, 1-204 months). No association was found between the extent or severity of disease and subsequent development of acute or chronic pouchitis. A positive correlation was found between the histopathologic score and the occurrence of clinical pouchitis (p=0.014). The presence of colonic metaplasia in the pouch biopsy was significantly correlated with a histopathologic diagnosis of pouchitis (p<0.0001, r=-0.449). Conclusions: Following RPC for MUC, the extent and severity of disease do not predict the subsequent development of pouchitis.
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页码：29 / 36
页数：7
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