Pouch Failures Following Ileal Pouch-anal Anastomosis for Ulcerative Colitis
| Autor: | Jørn Helmut Pachler, Søren Brandsborg, Anders Mark-Christensen, Niels Bent Johansen, Rune Erichsen, Charlotte Buchard Nørager, Louise Preisler, Mie Dilling Kjær, Niels Qvist, Jacob Rosenberg, Ole Thorlacius-Ussing, Søren Laurberg, Jens Hillingsø, Frederik Rønne Pachler |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
Postoperative Complications/epidemiology Adult medicine.medical_specialty medicine.medical_treatment Denmark Colonic Pouches Anastomosis Gastroenterology Primary sclerosing cholangitis pouch failure Cohort Studies 03 medical and health sciences Young Adult 0302 clinical medicine Postoperative Complications Ileal pouch–anal anastomosis Colitis Ulcerative/surgery Risk Factors Internal medicine medicine Journal Article Humans Registries Laparoscopy Colectomy ulcerative colitis Proportional Hazards Models medicine.diagnostic_test business.industry Proportional hazards model Incidence Hazard ratio Proctocolectomy Restorative restorative proctocolectomy Middle Aged medicine.disease Ulcerative colitis Surgery Colonic Pouches/adverse effects 030220 oncology & carcinogenesis Proctocolectomy Restorative/adverse effects 030211 gastroenterology & hepatology Colitis Ulcerative Female Pouch business |
| Zdroj: | Mark-Christensen, A, Erichsen, R, Brandsborg, S, Rønne Pachler, F, Nørager, C B, Johansen, N, Pachler, J H, Thorlacius-Ussing, O, Dilling Kjaer, M, Qvist, N, Preisler, L, Hillingsø, J, Rosenberg, J & Laurberg, S 2018, ' Pouch Failures Following Ileal Pouch-anal Anastomosis for Ulcerative Colitis ', Colorectal Disease, vol. 20, no. 1, pp. 44–52 . https://doi.org/10.1111/codi.13802 Mark-Christensen, A, Erichsen, R, Brandsborg, S, Rønne Pachler, F, Nørager, C B, Johansen, N B, Pachler, J H, Thorlacius-Ussing, O, Dilling Kjaer, M, Qvist, N, Preisler, L, Hillingsø, J, Rosenberg, J & Laurberg, S 2018, ' Pouch failures following ileal pouch-anal anastomosis for ulcerative colitis ', Colorectal Disease, vol. 20, no. 1, pp. 44-52 . https://doi.org/10.1111/codi.13802 Mark-Christensen, A, Erichsen, R, Brandsborg, S, Pachler, F R, Nørager, C B, Johansen, N, Pachler, J H, Thorlacius-Ussing, O, Kjaer, M D, Qvist, N, Preisler, L, Hillingsø, J, Rosenberg, J & Laurberg, S 2018, ' Pouch failures following ileal pouch-anal anastomosis for ulcerative colitis ', Colorectal Disease, vol. 20, no. 1, pp. 44-52 . https://doi.org/10.1111/codi.13802 |
| Popis: | Background The ileal pouch-anal anastomosis is a procedure offered to patients with ulcerative colitis who opt for restoration of bowel continuity. The aim of this study was to determine the risk of pouch failure and ascertain risk factors associated with failure. Method 1,991 patients with ulcerative colitis operated with ileal pouch-anal anastomosis in Denmark in the period 1980–2013 were included. Pouch failure was defined as excision of the pouch or presence of a stoma un-reversed within one year after its creation. We used Cox proportional hazards regression to explore the association between pouch failure and age, gender, synchronous colectomy, primary fecal diversion, annual hospital volume (very low=1-5 cases/year, low=6-10/year, intermediate=11-20/year, high>20/year), calendar year, laparoscopy, and primary sclerosing cholangitis. Results Over a median 11.4 years, 295 failures occurred, corresponding to 5-, 10-, and 20-year cumulative risks of 9.1%, 12.1%, and 18.2%, respectively. The risk of failure was higher for females (adjusted hazard ratio [aHR] 1.39, 95% CI: 1.10-1.75). Primary non-diversion (aHR 1.63, 95% CI: 1.11-2.41) and a low hospital volume (aHR, very low-volume vs. high-volume 2.30, 95% CI: 1.26-4.20) were also associated with a higher risk of failure. The risk of failure was not associated with calendar year, primary sclerosing cholangitis, synchronous colectomy, or laparoscopy. Conclusion In a cohort of patients with ulcerative colitis and ileal pouch-anal anastomosis from Denmark, where pouch surgery is centralized, females had a higher risk of pouch failure. Of modifiable factors, low hospital volume and non-diversion were associated with a higher risk of pouch failure. This article is protected by copyright. All rights reserved. |
| Databáze: | OpenAIRE |
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