24 Endoscopic and Clinical Characteristics of Pouchitis Involving the Rectal Cuff in Patients With Inflammatory Bowel Disease Treated by Proctocolectomy With Ileal Pouch-Anal Anastomosis

Akiyama, Shintaro; Ollech, Jacob; Rai, Victoria; Glick, Laura; Singer, Jorie; Karpin, Jordan; Rodriguez, Tina G.; Yi, Yangtian; Shaffer, Seth; Cohen, Russell D.; Hurst, Roger D.; Hyman, Neil; Dalal, Sushila; Sakuraba, Atsushi; Pekow, Joel; Rubin, David T.

doi:10.1053/j.gastro.2019.11.085

Cited by 1 publication

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“… 59 60 Pouchitis can develop in 80% of adult patients after RP-IPAA, significantly impairing quality of life. 61 62 Literature suggests similar pouchitis rates between diverted versus undiverted groups, likely due to comparable operative techniques for building the IPAA. In fact, Dolgin et al 24 reported no significant difference between the J-pouch and ileostomy versus without ileostomy procedures, in terms of complications or functional outcomes and no patient developed a significant pouch complication in either group.…”

Section: Discussionmentioning

confidence: 97%

“…Sixty per cent of affected children suffer from recurrent episodes and 5%–10% can develop chronic pouchitis 59 60. Pouchitis can develop in 80% of adult patients after RP-IPAA, significantly impairing quality of life 61 62. Literature suggests similar pouchitis rates between diverted versus undiverted groups, likely due to comparable operative techniques for building the IPAA.…”

Section: Discussionmentioning

confidence: 99%

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Postoperative complications of colectomy and J-pouch with ileostomy versus without ileostomy in children with inflammatory bowel diseases: a systematic review and meta-analysis

Oltean

Travis

Kaur

et al. 2022

World Jnl Ped Surgery

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BackgroundThe efficacy of performing a restorative proctocolectomy and J-pouch ileoanal anastomosis without diverting ileostomy in children with inflammatory bowel disease has been a longstanding debate. A systematic review and meta-analysis is presented comparing the occurrence of postoperative complications in children who underwent either the pouch-anal anastomosis (IPAA) with ileostomy (diverted) versus the undiverted procedure.MethodsRecords were sourced from CINAHL, CENTRAL, EMBASE and MEDLINE databases. Studies followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and compared postoperative complications in pediatric patients diagnosed with inflammatory diseases aged less than 18 years who underwent J-pouch with ileostomy versus without ileostomy. The primary outcome was the occurrence of postoperative leaks, and the secondary outcomes were presence of postoperative small bowel obstruction (SBO), pouchitis, stricture and fistula complications. A random-effects meta-analysis was used.ResultsTwenty-three observational studies in the systematic review were included with 658 patients (83% diverted, 17% undiverted). Pooled estimates showed no difference in occurrence of leaks in children who underwent J-pouch/IPAA with ileostomy versus without (odds ratio (OR) 0.54, 95% confidence interval (CI) 0.17 to 1.64, I2=16%). There was no difference in the occurrence of SBO, pouchitis or strictures in children who underwent J-pouch/IPAA with ileostomy versus without (SBO: OR 2.27, 95% CI 0.52 to 9.92, I2=0%, pouchitis: OR 1.76, 95% CI 0.95 to 3.24, I2=0%, strictures: OR 2.72, 95% CI 0.44 to 16.69, I2=66%).ConclusionThe meta-analysis did not find differences in the occurrence of complications in pediatric patients who underwent the IPAA with ileostomy procedure versus without ileostomy.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%