Do medications affect outcomes in pelvic pouch construction?

Amy Lightner

Research output: Contribution to journalArticle

Abstract

Ileal pouch anal anastomosis is the preferred operation for restoration of intestinal continuity in patients with ulcerative colitis due to favorable functional outcomes and quality of life. However, up to 30% can develop postoperative complications, of which pelvic sepsis is the most dreaded due to impaired pouch function and increased rates of pouch failure. Several modifiable risk factors are associated with postoperative pelvic sepsis including obesity, poor nutritional status, anemia, and immunosuppressive therapy. While the evidence regarding the effect of immunosuppressive therapy on adverse postoperative outcomes is controversial, there is mounting data to suggest the operation performed at the time of immunosuppression exposure is critical for subsequent pouch outcomes. This has resulted in an increased number of pouches being performed as a modified 2-stage or 3-stage approach, a conservative yet safe approach to avoid potential deleterious effects of immunosuppression at the critical step of pouch formation.

Original languageEnglish (US)
JournalSeminars in Colon and Rectal Surgery
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Colonic Pouches
Immunosuppressive Agents
Immunosuppression
Sepsis
Nutritional Status
Ulcerative Colitis
Anemia
Obesity
Quality of Life
Therapeutics

Keywords

  • Biologics
  • Ileal pouch anal anastomosis
  • Immunosuppression
  • Pelvic sepsis
  • Ulcerative colitis

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

Cite this

Do medications affect outcomes in pelvic pouch construction? / Lightner, Amy.

In: Seminars in Colon and Rectal Surgery, 01.01.2019.

Research output: Contribution to journalArticle

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