Imperial College London School of Medicine, London, UK.
Department of Colorectal Surgery, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.
J Crohns Colitis. 2024 Mar 1;18(3):479-487. doi: 10.1093/ecco-jcc/jjad163.
To summarise frequency, type, and heterogeneity of patient-reported outcomes measures [PROMs] in papers reporting on outcomes after ileal pouch anal anastomosis [IPAA].
Prevalence of ulcerative colitis [UC] has risen in Western countries, and one in three patients requires surgery. IPAA is a frequently performed procedure for UC, and a lack of standardisation is manifest in reporting outcomes for inflammatory bowel disease [IBD] despite the clear need for inclusion of PROMs as primary outcomes in IBD trials.
Scopus, Pubmed, and Web of Science databases were searched from January 2010 to January 2023 for studies investigating outcomes in IPAA surgery. The primary outcome was the proportion of studies reporting outcomes for IPAA surgery for UC, which included PROMs.
The search identified a total of 8028 studies which, after de-duplication and exclusion, were reduced to 79 articles assessing outcomes after IPAA surgery. In all 44 [55.7%] reported PROMs, with 23 including validated questionnaires and 21 papers using authors' questions, 22 different PROMs were identified, with bowel function as the most investigated item. The majority of studies [67/79, 85%] were retrospective, only 14/79 [18%] were prospective papers and only two were [2.5%] randomised, controlled trials.
Only half of the papers reviewed used PROMs. The main reported item is bowel function and urogenital, social, and psychological functions are the most neglected. There is lack of standardisation for use of PROMs in IPAA. Complexity of UC and of outcomes after IPAA demands a change in clinical practice and follow-up, given how crucial PROMs are, compared with their non-routine use.
总结报告回肠贮袋肛管吻合术（IPAA）术后结局的文献中患者报告结局测量（PROMs）的频率、类型和异质性。
西方国家溃疡性结肠炎（UC）的患病率有所上升，三分之一的患者需要手术。IPAA 是 UC 常用的手术方法，但尽管在炎症性肠病（IBD）临床试验中纳入 PROMs 作为主要结局非常重要，但报告 IBD 结局的方法缺乏标准化。
从 2010 年 1 月至 2023 年 1 月，在 Scopus、Pubmed 和 Web of Science 数据库中搜索调查 IPAA 手术结局的研究。主要结局是报告 UC 行 IPAA 手术结局的研究比例，其中包括 PROMs。
共检索到 8028 项研究，经过去重和排除，最终有 79 项研究评估了 IPAA 手术后的结局。所有研究中，44 项[55.7%]报告了 PROMs，其中 23 项包含经过验证的问卷，21 项使用作者提出的问题，共确定了 22 种不同的 PROMs，以肠道功能为研究最多的项目。大多数研究[67/79，85%]为回顾性研究，只有 14/79 [18%]为前瞻性研究，仅有 2 项[2.5%]为随机对照试验。
只有一半的研究使用了 PROMs。主要报告的项目是肠道功能，而泌尿生殖、社会和心理功能是最被忽视的。在 IPAA 中使用 PROMs 缺乏标准化。UC 的复杂性和 IPAA 术后结局要求改变临床实践和随访，因为 PROMs 非常重要，而目前它们的使用并不常规。
