Bresteau Clément, Amiot Aurélien, Kirchgesner Julien, de'Angelis Nicola, Lefevre Jérémie H, Bouhnik Yoram, Panis Yves, Beaugerie Laurent, Allez Matthieu, Brouquet Antoine, Carbonnel Franck, Meyer Antoine
Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Université Paris Saclay, CHU Bicêtre, 78, rue du Général Leclerc, Le Kremlin Bicêtre 94270, France.
Assitance-Publique-Hôpitaux de Paris, Hôpitaux Universitaires Henri Mondor, EA7375, Universite Paris Est Creteil, Créteil, France.
Dig Liver Dis. 2021 Sep;53(9):1128-1135. doi: 10.1016/j.dld.2021.03.027. Epub 2021 Apr 27.
Restorative proctocolectomy with ileal-pouch anal-anastomosis (IPAA) is the operation of choice for patients with ulcerative colitis (UC) or with inflammatory bowel diseases unclassified (IBDU).
to assess the incidence and risk factors of chronic pouchitis (CP) and Crohn's disease of the pouch (CDP) in patients with UC or IBDU.
We conducted a retrospective study. We included consecutive patients who underwent IPAA between 2011 and 2019. The main outcome was the occurrence of CP or CDP. We looked for risk factors with multivariable and a least absolute shrinkage and selection operator (LASSO) Cox models.
247 patients were included. The 5-year cumulative incidence of CP or CDP was 35.3% (95%CI: 26.2-43.2). In multivariable analysis, diagnosis of IBDU, age less than 35 years at surgery and extra-intestinal manifestations other than articular and primary sclerosing cholangitis were associated with higher incidence. The LASSO analysis identified these three prognostic factors and articular manifestations. In patients with two or more prognostic factors, 5-year cumulative incidence, was 65.2% (95%CI: 41.8-79.2).
Five years after IPAA, approximately one-third of patients had either CP or CDP. Risk factors were IBDU, an age less than 35 years at surgery, articular manifestations and other extra-intestinal manifestations.
回肠储袋肛管吻合术（IPAA）行结直肠切除重建术是溃疡性结肠炎（UC）或未分类炎症性肠病（IBDU）患者的首选手术方式。
评估UC或IBDU患者慢性储袋炎（CP）和储袋克罗恩病（CDP）的发病率及危险因素。
我们进行了一项回顾性研究。纳入2011年至2019年间连续接受IPAA手术的患者。主要观察指标为CP或CDP的发生情况。我们通过多变量及最小绝对收缩和选择算子（LASSO）Cox模型寻找危险因素。
共纳入247例患者。CP或CDP的5年累积发病率为35.3%（95%CI：26.2 - 43.2）。多变量分析显示，IBDU诊断、手术时年龄小于35岁以及除关节和原发性硬化性胆管炎外的肠外表现与较高发病率相关。LASSO分析确定了这三个预后因素及关节表现。有两个或更多预后因素的患者，5年累积发病率为65.2%（95%CI：41.8 - 79.2）。
IPAA术后五年，约三分之一的患者发生CP或CDP。危险因素为IBDU、手术时年龄小于35岁、关节表现及其他肠外表现。
