Evaluation of preoperative predictors of development of pouchitis after ileal-pouch-anastomosis in ulcerative colitis
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Tarih
2012
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Elsevier Masson
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Introduction: In this retrospective study, we aimed to evaluate preoperative predictive risk factors for development of pouchitis in the ulcerative colitis (UC) patients with Heal pouch-anal anastomosis (IPAA). Methods: The records of UC patients who underwent IPAA surgery and were under follow-up in the inflammatory bowel disease (IBD) clinic of our hospital between January 1994 and September 2009 were retrieved. Preoperative clinical, biochemical, and endoscopic findings, as well as preoperative endoscopic activity index (EAI), preoperative disease activity index (DAI) and operative characteristics were recorded. Patients with endoscopic, histological and clinical findings consistent with pouchitis were identified. Results: Out of a total of 49 patients who underwent IPAA for UC, pouchitis was identified in 20 (40.8%) of them. Overall, 37 (75.5%) patients had chronic active disease, eight (16.3%) patients had chronic intermittent disease with frequent relapses, and four (8.2%) patients had fulminant colitis prior to surgery. There was a statistically significant difference (P = 0.02) among these patients for the development of pouchitis in postoperative period. The mean EAI (10.1 vs. 8.7, P = 0.02) and DAI (10.0 vs. 8.6, P < 0.01) in patients with pouchitis were significantly higher than that of patients who did not develop pouchitis. Multivariate analysis revealed steroid dependency (P = 0.02), and a higher DAI (P = 0.02) to be independent risk factors for the development of pouchitis. Conclusion: A more severe preoperative clinical course and steroid dependency, as well as higher endoscopic and disease activity scores may be useful as preoperative predictors of subsequent pouchitis in UC patients undergoing IPAA surgery. (c) 2012 Elsevier Masson SAS. All rights reserved.
Açıklama
Anahtar Kelimeler
Ulcerative Colitis
Kaynak
Clinics And Research In Hepatology And Gastroenterology
WoS Q Değeri
Q4
Scopus Q Değeri
Q3
Cilt
36
Sayı
6