Current Perspectives on Indications for Ileal Pouch-Anal Anastomosis in Older Patients.

The population of older patients with inflammatory bowel disease (IBD) is expected to continue to increase in the coming decades, which necessitates and improved understanding of the critical issues faced by patients in this population. Although restorative proctocolectomy with IPAA remains the surgical procedure of choice for the majority of patients with medically refractory ulcerative colitis (UC) and UC-related dysplasia, the evidence surrounding surgery for older patients UC remains sparse. In particular, comparisons of outcomes among older and younger patients undergoing IPAA and comparisons between older patients undergoing IPAA and those undergoing proctocolectomy with end ileostomy remain an understudied and important issue, as evidence in this area will be used to guide patient-centered surgical choices among older patients who require colectomy for UC. In this narrative review, we review the available literature regarding IPAA for older patients, as well as the pre-, peri-, and postoperative factors that may influence outcomes in this population.

在未来几十年，老年炎症性肠病（IBD）患者的数量预计将持续增加，这就需要更好地了解这一人群患者所面临的关键问题。尽管回肠储袋肛管吻合术（IPAA）对于大多数药物难治性溃疡性结肠炎（UC）和UC相关异型增生患者仍是首选的手术方式，但有关老年UC患者手术的证据仍然很少。特别是，接受IPAA的老年和年轻患者之间的结果比较，以及接受IPAA的老年患者与接受直肠结肠切除术加末端回肠造口术的老年患者之间的比较，仍然是一个研究不足但很重要的问题，因为这方面的证据将用于指导因UC需要结肠切除术的老年患者做出以患者为中心的手术选择。在这篇叙述性综述中，我们回顾了有关老年患者IPAA的现有文献，以及可能影响这一人群结果的术前、围手术期和术后因素。