Risk Factors for Short- and Long-Term Complications of Ileal Pouch Surgery

Abstract

Abstract Restorative proctocolectomy with ileal “J,” “W,” or “S” pouch-anal anastomosis (IPAA) is the treatment of choice in the majority of patients who require colectomy for medically refractory ulcerative colitis (UC), colitis-associated dysplasia and/or cancer, as well as familial adenomatous polyposis (FAP). While the IPAA procedure leads to significant improvement in patient’s quality of life, the outcome of this procedure may be compromised by a number of adverse sequelae including short-term complications such as anastomotic leakage, pelvic abscess, and wound infection and long-term complications such as pouchitis, Crohn’s disease of the pouch, fistulas, and strictures. Those postoperative complications adversely affect the outcome of IPAA and patients’ quality of life, or even pouch failure with pouch excision, revision, or permanent fecal diversion. Knowledge of risk factors for the complications helps us to understand the etiology and disease process and optimize strategies for their prevention.