Transmural Inflammation, Ileitis, and Granulomas at the Time of Proctocolectomy in Patients with Ulcerative Colitis Do Not Predict Future Development of Pouchitis

Background: The most common complication following ileal pouch-anal anastomosis (IPAA) in patients with ulcerative colitis (UC) is pouchitis. Our study aimed to investigate the relationship between histopathologic findings of ileitis, granuloma, or transmural inflammation on the colectomy specimen o...

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Autores principales:	Edward L. Barnes, Joshua Hudson, Scott Esckilsen, Bharati Kochar, Michael D. Kappelman, Millie D. Long, Mark Koruda, Robert S. Sandler, Hans H. Herfarth
Formato:	article
Lenguaje:	EN
Publicado:	Karger Publishers 2021
Materias:	pathology pouchitis ileal pouch-anal anastomosis histology Diseases of the digestive system. Gastroenterology RC799-869
Acceso en línea:	https://doaj.org/article/dfcbf5036e31493982e6e42d6e4f7583
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spelling	oai:doaj.org-article:dfcbf5036e31493982e6e42d6e4f75832021-11-04T14:40:32ZTransmural Inflammation, Ileitis, and Granulomas at the Time of Proctocolectomy in Patients with Ulcerative Colitis Do Not Predict Future Development of Pouchitis2296-94032296-936510.1159/000519325https://doaj.org/article/dfcbf5036e31493982e6e42d6e4f75832021-10-01T00:00:00Zhttps://www.karger.com/Article/FullText/519325https://doaj.org/toc/2296-9403https://doaj.org/toc/2296-9365Background: The most common complication following ileal pouch-anal anastomosis (IPAA) in patients with ulcerative colitis (UC) is pouchitis. Our study aimed to investigate the relationship between histopathologic findings of ileitis, granuloma, or transmural inflammation on the colectomy specimen of patients with clinically and endoscopically diagnosed UC and the development of pouchitis within the first 2 years after IPAA. Methods: We performed a retrospective cohort study evaluating patients undergoing colectomy with IPAA for UC between January 1, 2004 and December 31, 2016. Bivariate analyses were conducted to evaluate the relationship between clinical factors and the development of pouchitis. We performed multivariate logistic regression to evaluate the relationship between histologic, clinical, and demographic factors at the time of colectomy and subsequent development of pouchitis. Results: Among 626 patients, pouchitis occurred in 246 (39%). Patients with primary sclerosing cholangitis were more likely to develop pouchitis (adjusted odds ratio [aOR] 2.81, 95% confidence interval [CI] 1.02–7.72), as were patients with a family history of inflammatory bowel disease (aOR 1.75, 95% CI 1.11–2.77). Histologic findings of ileitis, granuloma, or transmural inflammation were not associated with an increased odds of developing pouchitis (aOR 0.70, 95% CI 0.45–1.08). Discussion/Conclusion: Patients with ileitis, granulomas, or transmural inflammation at the time of colectomy were not at greater risk for development of pouchitis in the 2 years after IPAA. These pathological findings should not preclude IPAA for UC.Edward L. BarnesJoshua HudsonScott EsckilsenBharati KocharMichael D. KappelmanMillie D. LongMark KorudaRobert S. SandlerHans H. HerfarthKarger Publishersarticlepathologypouchitisileal pouch-anal anastomosishistologyDiseases of the digestive system. GastroenterologyRC799-869ENInflammatory Intestinal Diseases, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	pathology pouchitis ileal pouch-anal anastomosis histology Diseases of the digestive system. Gastroenterology RC799-869
spellingShingle	pathology pouchitis ileal pouch-anal anastomosis histology Diseases of the digestive system. Gastroenterology RC799-869 Edward L. Barnes Joshua Hudson Scott Esckilsen Bharati Kochar Michael D. Kappelman Millie D. Long Mark Koruda Robert S. Sandler Hans H. Herfarth Transmural Inflammation, Ileitis, and Granulomas at the Time of Proctocolectomy in Patients with Ulcerative Colitis Do Not Predict Future Development of Pouchitis
description	Background: The most common complication following ileal pouch-anal anastomosis (IPAA) in patients with ulcerative colitis (UC) is pouchitis. Our study aimed to investigate the relationship between histopathologic findings of ileitis, granuloma, or transmural inflammation on the colectomy specimen of patients with clinically and endoscopically diagnosed UC and the development of pouchitis within the first 2 years after IPAA. Methods: We performed a retrospective cohort study evaluating patients undergoing colectomy with IPAA for UC between January 1, 2004 and December 31, 2016. Bivariate analyses were conducted to evaluate the relationship between clinical factors and the development of pouchitis. We performed multivariate logistic regression to evaluate the relationship between histologic, clinical, and demographic factors at the time of colectomy and subsequent development of pouchitis. Results: Among 626 patients, pouchitis occurred in 246 (39%). Patients with primary sclerosing cholangitis were more likely to develop pouchitis (adjusted odds ratio [aOR] 2.81, 95% confidence interval [CI] 1.02–7.72), as were patients with a family history of inflammatory bowel disease (aOR 1.75, 95% CI 1.11–2.77). Histologic findings of ileitis, granuloma, or transmural inflammation were not associated with an increased odds of developing pouchitis (aOR 0.70, 95% CI 0.45–1.08). Discussion/Conclusion: Patients with ileitis, granulomas, or transmural inflammation at the time of colectomy were not at greater risk for development of pouchitis in the 2 years after IPAA. These pathological findings should not preclude IPAA for UC.
format	article
author	Edward L. Barnes Joshua Hudson Scott Esckilsen Bharati Kochar Michael D. Kappelman Millie D. Long Mark Koruda Robert S. Sandler Hans H. Herfarth
author_facet	Edward L. Barnes Joshua Hudson Scott Esckilsen Bharati Kochar Michael D. Kappelman Millie D. Long Mark Koruda Robert S. Sandler Hans H. Herfarth
author_sort	Edward L. Barnes
title	Transmural Inflammation, Ileitis, and Granulomas at the Time of Proctocolectomy in Patients with Ulcerative Colitis Do Not Predict Future Development of Pouchitis
title_short	Transmural Inflammation, Ileitis, and Granulomas at the Time of Proctocolectomy in Patients with Ulcerative Colitis Do Not Predict Future Development of Pouchitis
title_full	Transmural Inflammation, Ileitis, and Granulomas at the Time of Proctocolectomy in Patients with Ulcerative Colitis Do Not Predict Future Development of Pouchitis
title_fullStr	Transmural Inflammation, Ileitis, and Granulomas at the Time of Proctocolectomy in Patients with Ulcerative Colitis Do Not Predict Future Development of Pouchitis
title_full_unstemmed	Transmural Inflammation, Ileitis, and Granulomas at the Time of Proctocolectomy in Patients with Ulcerative Colitis Do Not Predict Future Development of Pouchitis
title_sort	transmural inflammation, ileitis, and granulomas at the time of proctocolectomy in patients with ulcerative colitis do not predict future development of pouchitis
publisher	Karger Publishers
publishDate	2021
url	https://doaj.org/article/dfcbf5036e31493982e6e42d6e4f7583
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Transmural Inflammation, Ileitis, and Granulomas at the Time of Proctocolectomy in Patients with Ulcerative Colitis Do Not Predict Future Development of Pouchitis

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