Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Campus Box #7080 130 Mason Farm Road, 27599-7080, Chapel Hill, NC, USA.
Multidisciplinary Center for Inflammatory Bowel Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Curr Gastroenterol Rep. 2022 Nov;24(11):127-136. doi: 10.1007/s11894-022-00850-9. Epub 2022 Oct 18.
Restorative proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis has been associated with multiple short- and long-term complications. In this review, we examine the role of biomarkers, imaging, and pouchoscopy in the assessment of patients after ileal pouch-anal anastomosis, with a particular focus on the emergence of novel biomarkers and techniques for evaluating and risk stratifying patients after this procedure in the hopes of improving outcomes in this specific population.
There are indications that that the incidence of pouchitis may be increasing in recent decades. Calprotectin and other non-invasive imaging tests such as ultrasound may offer advantages in distinguishing patients with inflammatory conditions of the pouch from other etiologies. In the search for other biomarkers that may identify patients at risk for inflammatory conditions of the pouch, the stool microbiota and metabolomics may play a key role in identifying those patients at greatest risk for complications. Advances in biomarkers, imaging, and standardized pouchoscopy scoring offer immediate improvements in clinical care and will prompt future research efforts.
溃疡性结肠炎的直肠结肠切除术联合回肠袋肛管吻合术与多种短期和长期并发症相关。在这篇综述中，我们检查了生物标志物、影像学和袋镜检查在回肠袋肛管吻合术后患者评估中的作用，特别关注新出现的生物标志物和技术，以评估和分层该手术后患者的风险，以期改善该特定人群的结局。
有迹象表明，近几十年来 pouchitis 的发病率可能在增加。钙卫蛋白和其他非侵入性影像学检查，如超声，可能在鉴别 pouch 炎症与其他病因方面具有优势。在寻找可能识别有 pouch 炎症风险的患者的其他生物标志物方面，粪便微生物组和代谢组学可能在识别那些发生并发症风险最大的患者方面发挥关键作用。生物标志物、影像学和标准化袋镜检查评分的进展提供了即时的临床护理改善，并将促使未来的研究工作。
