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- Title
Review of current practice and outcomes following ileoanal pouch surgery: lessons learned from the Ileoanal Pouch Registry and the 2017 Ileoanal Pouch Report.
- Authors
Worley, G. H. T.; Fearnhead, N. S.; Brown, S. R.; Acheson, A. G.; Lee, M. J.; Faiz, O. D.; The Association Of Coloproctology Of Great Britain And Ireland (acpgbi) Inflammatory Bowel Disease Clinical Advisory Group, Commentators In The 2017 Acpgbi Ileoanal Pouch Report, And Ileoanal Pouch Registry Contributors
- Abstract
Abstract: Aim: The second Association of Coloproctology of Great Britain and Ireland (ACPGBI) Ileoanal Pouch Registry (IPR) report was released in July 2017 following a first report in 2012. This article provides a summary of data derived from the most recent IPR report (2017 Ileoanal Pouch Report. https://www.acpgbi.org.uk/content/uploads/2016/07/Ileoanal-Pouch-Report-2017-FINAL.compressed.pdf). Method: The IPR is an electronic database of voluntarily submitted data including patient demographics, disease, intra‐operative and postoperative factors submitted by consultant surgeons or delegates. Data up to 31 March 2017 have been analysed for this report. Results: A total of 5352 pouch operations were carried out at 76 UK and four European centres by 154 surgeons over four decades. Recorded procedures have increased over time but data submission is voluntary and underestimates actual volume. Significant variation exists in institutional volume; 73 centres entered data on patients undergoing pouch surgery during the past 5 years. Of these, 44 centres have submitted ≤ 10 cases, with 10 centres submitting one patient and nine centres two cases. Since 2013, minimal access surgery has been employed in 54% of cases. Rectal dissection was undertaken in the total mesorectal excision plane in 69%. J‐pouch configuration was used in 99% of cases and 90% of pouch–anal anastomoses were performed using a stapled technique. Including all years, the IPR rate of pelvic sepsis was 9.4% and the rate of pouch failure was 4.7%. Conclusion: The IPR holds the largest voluntary repository of data on ileoanal pouch surgery. The second report from the IPR records marked refinements in surgical technique over time but also highlights wide variation in institutional caseload and outcome across the UK.
- Subjects
RESTORATIVE proctocolectomy; ULCERATIVE colitis; ADENOMATOUS polyposis coli; QUALITY of life; ENDOSCOPIC surgery
- Publication
Colorectal Disease, 2018, Vol 20, Issue 10, p913
- ISSN
1462-8910
- Publication type
Article
- DOI
10.1111/codi.14316