Risk factors for Crohn's disease-like pouch in ulcerative colitis patients with ileal pouch-anal anastomosis
10.3760/cma.j.cn101480-20241223-00146
- VernacularTitle:溃疡性结肠炎回肠储袋肛管吻合术后克罗恩病样储袋的影响因素分析
- Author:
Yinan YAN
1
;
Juan WEI
;
Zhao YANG
;
Ya YANG
;
Hui TAO
;
Liuying LI
;
Hongqin WANG
;
Yuanyi ZHAO
;
Feng ZHU
;
Ji XUAN
;
Jianfeng GONG
;
Fangyu WANG
Author Information
1. 南京大学医学院，南京 210046
- Publication Type:Journal Article
- Keywords:
Ulcerative colitis;
Crohn's disease-like pouch;
Ileal pouch-anal anastomosis
- From:
Chinese Journal of Inflammatory Bowel Diseases
2025;09(3):211-217
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the incidence of Crohn's disease-like pouch (CDP) after ileal pouch-anal anastomosis (IPAA) and analyze the clinical characteristics and risk factors in ulcerative colitis (UC) patients.Methods:A retrospective cohort study was conducted. One hundred and eighty-two UC patients undergoing IPAA at Jinling Hospital affiliated to Nanjing University from November 2003 to November 2024 were enrolled. Patients were categorized into CDP and non-CDP groups. Clinical features and prognosis were compared, and multivariate Cox regression was performed to identify risk factors for CDP.Results:A total of 182 UC patients were included, with a median follow-up time of 45.00 (30.00, 75.25) months. The patients were divided into two groups based on the diagnosis of CDP, with 23 patients (12.64%) in the CDP group and 159 patients (87.30%) in the non-CDP group. Compared to the non-CDP group, patients in the CDP group had a lower body mass index (BMI) ( Z=-2.87, P=0.004), and were more likely to develop early postoperative pouchitis (χ 2=4.50, P=0.034). The median time from ileostomy closure to the development of CDP was 12 .00 (6.00, 28.00) months. Cox regression analysis showed that a preoperative BMI<18.5 kg/m 2 ( HR=2.84, 95% CI: 1.24~6.49, P=0.013) and early postoperative pouchitis ( HR=3.11, 95% CI: 1.22~7.93, P=0.018) were associated with an increased risk of CDP. Conclusions:Preoperative low BMI and pouchitis occurring within 3 months postoperatively are significant risk factors for CDP. Close monitoring and early intervention are recommended for high-risk patients.
