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Clinical Discrimination of Chronic Pouchitis After Ileal Pouch-Anal Anastomosis in Patients with Ulcerative Colitis

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Purpose

We aimed to identify predictive factors for the development of chronic pouchitis after ileal pouch-anal anastomosis in patients with ulcerative colitis.

Methods

Three hundred eighty-seven patients who underwent ileal pouch-anal anastomosis for diagnosis of ulcerative colitis from January 2002 to March 2019 were included in this retrospective analysis.

Results

Of 115 patients with pouchitis, 40 patients exhibited acute pouchitis, and 75 patients exhibited chronic pouchitis. Of 75 patients with chronic pouchitis, 11 patients were diagnosed with chronic antibiotic-refractory pouchitis. Multivariate analysis revealed that early pouchitis onset and modified Pouchitis Disease Activity Index score ≥ 7 were independent predictive factors for chronic pouchitis (p = 0.0004 and p = 0.029, respectively). Mean onset of pouchitis after intestinal continuity was significantly earlier in patients with chronic pouchitis than in patients with acute pouchitis (acute pouchitis vs. chronic pouchitis: 3.72 ± 2.98 years vs. 1.85 ± 2.40 years, p < 0.0001). Total modified Pouchitis Disease Activity Index score was significantly higher in patients with chronic pouchitis than in patients with acute pouchitis (acute pouchitis vs. chronic pouchitis: 5.9 ± 1.2 vs. 6.9 ± 1.6, p = 0.0020).

Conclusion

Patients with ulcerative colitis were more likely to develop chronic pouchitis if they exhibited early onset or severe disease activity at onset. Evaluation of both factors can aid in early treatment decisions to alleviate chronic pouchitis.

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Acknowledgments

We thank Ryan Chastain-Gross, Ph.D., from Edanz Group (https://en-author-services.edanzgroup.com) for editing a draft of this manuscript.

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Authors and Affiliations

  1. Division of Reparative Medicine, Departments of Gastrointestinal and Pediatric Surgery, Institute of Life Sciences, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan

    Yoshiki Okita, Masaki Ohi, Takahito Kitajima, Tadanobu Shimura, Akira Yamamoto, Hiroyuki Fujikawa, Yoshinaga Okugawa, Kohei Matsushita, Yuhki Koike, Mikihiro Inoue, Keiichi Uchida & Yuji Toiyama

Authors
  1. Yoshiki Okita
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  2. Masaki Ohi
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  3. Takahito Kitajima
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  4. Tadanobu Shimura
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  5. Akira Yamamoto
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  6. Hiroyuki Fujikawa
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  7. Yoshinaga Okugawa
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  8. Kohei Matsushita
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  9. Yuhki Koike
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  10. Mikihiro Inoue
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  11. Keiichi Uchida
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  12. Yuji Toiyama
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Contributions

Y Okita: project development, data analysis and collection, manuscript writing

M Ohi: project development, data analysis

T Kitajima: data collection

T Shimura: data collection

A Yamamoto: data collection

H Fujikawa: data collection

Y Okugawa: data analysis

Kohei Matsushita: data collection

Y Koike: data collection

M Inoue: data collection

K Uchida: data analysis

Y Toiyama: project development, manuscript editing

Corresponding author

Correspondence to Yoshiki Okita.

Ethics declarations

This study was approved by the Institutional Review Board. Informed consent was obtained from all patients who agreed to have their personal data used for research purposes.

Conflict of Interest

The authors declare that they have no conflict of interest.

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Okita, Y., Ohi, M., Kitajima, T. et al. Clinical Discrimination of Chronic Pouchitis After Ileal Pouch-Anal Anastomosis in Patients with Ulcerative Colitis. J Gastrointest Surg 25, 2047–2054 (2021). https://doi.org/10.1007/s11605-020-04842-w

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  • DOI: https://doi.org/10.1007/s11605-020-04842-w

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