Predictors of permanent ileostomy after restorative proctocolectomy

The British Journal of Surgery
A G WibmerJ-P Ritz

Abstract

Proctocolectomy with ileal pouch-anal anastomosis (IPAA) is a surgical approach for ulcerative colitis and familial adenomatous polyposis. This study evaluated predictors of the need for a permanent ileostomy to identify patients at high risk of IPAA failure. This was a retrospective analysis of patients who underwent proctocolectomy and IPAA between 1997 and 2008. A logistic regression model was used for multivariable analysis of potential risk factors. Proctocolectomy was combined with IPAA in 185 patients, of whom 169 had a loop ileostomy formed. IPAA and ileostomy closure were successful in 162 patients (87.6 per cent). Reasons for not closing the ileostomy included pouch failure (16 patients), patient choice (5) and death (2). Thus one in eight patients had a permanent ileostomy after planned IPAA. Age was the major predictor of the need for a permanent ileostomy in multivariable analysis (P = 0.002) with a probability of more than 25 per cent in patients aged over 60 years. However, advancing age was associated with colitis, co-morbidity, obesity and corticosteroid use. The probability of the need for a permanent ileostomy after IPAA increases with age.

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Citations

Sep 17, 2011·Langenbeck's Archives of Surgery·Malika Bennis, Emmanuel Tiret
Jul 13, 2013·Inflammatory Bowel Diseases·Alastair WindsorSubrata Ghosh
Jun 27, 2014·World Journal of Gastroenterology : WJG·Seung-Bum RyooKyu Joo Park
Apr 18, 2015·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·C NordenvallP J Nilsson
Sep 4, 2012·The Journal of Surgical Research·Bodil GesslerEva Angenete
Mar 17, 2017·Inflammatory Bowel Diseases·Amy L LightnerJohn H Pemberton
Jun 13, 2015·Scandinavian Journal of Surgery : SJS : Official Organ for the Finnish Surgical Society and the Scandinavian Surgical Society·I HelavirtaP Aitola
Apr 10, 2019·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·T RombeyN S Fearnhead
Nov 7, 2015·Diseases of the Colon and Rectum·HyungJin KimJames Church
Jul 30, 2014·World Journal of Gastroenterology : WJG·Bruno César da SilvaGenoile Oliveira Santana

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