Ileal pouch anal anastomosis (IPAA) is the treatment choice for most patients with ulcerative colitis and familial adenomatous polyposis who require surgery.
However, there is little information on factors related to ileal pouch failure, or predictors of risk for patients undergoing IPAA surgery.
In this study, doctors identified risk factors associated with ileal pouch failure. They also constructed a multifactorial model for quantifying the risk of failure in individual patients.
The team evaluated 1965 patients who underwent restorative proctocolectomy between 1983 and 2001.
The primary end point measured by the team was ileal pouch failure during the follow-up period.
|5-year ileal pouch survival was 96%.|
|Annals of Surgery|
They developed a "CCF ileal pouch failure" model using a parametric survival analysis and a split-sample validation technique for model training and testing.
The doctors found that the median patient follow-up was 4.1 years.
They determined that 5-year ileal pouch survival was 96%.
Predictors of pouch survival included patient diagnosis, prior anal pathology, abnormal anal manometry, patient comorbidity, pouch-perineal or pouch-vaginal fistulae, pelvic sepsis, anastomotic stricture and separation.
The team found that their model accurately predicted the risk of ileal pouch failure.
Dr Victor Fazio's team concluded, "The CCF ileal pouch failure model is a simple and accurate way of predicting the risk of ileal pouch failure in clinical practice on a longitudinal basis".
"It may play an important role in providing risk estimates for patients wishing to make informed choices on the type of treatment offered to them".