Preoperative Endoscopic Activity Predicts the Occurrence of Pouchitis After Ileal Pouch-Anal Anastomosis in Ulcerative Colitis: A Multicenter Retrospective Study in China.
Preoperative Endoscopic Activity Predicts the Occurrence of Pouchitis After Ileal Pouch-Anal Anastomosis in Ulcerative Colitis: A Multicenter Retrospective Study in China.
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术前内镜活动预测溃疡性结肠炎回肠储袋-肛门吻合术后储袋炎的发生：中国多中心回顾性研究
DOI：
10.3389/fsurg.2021.740349
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发表时间：
2021
影响因子：
1.8
通讯作者：
Du P
中科院分区：
文献类型：
--
作者：
Xu W;Tang W;Ding W;Hu H;Chen W;Qian Q;Cui L;Ding Z;Du P
背景：袋炎是溃疡性结肠炎（UC）患者回肠袋-肛门吻合术（IPAA）后最常见的长期并发症。溃疡性结肠炎内镜严重程度指数（UCEIS）和Mayo内镜评分（MES）是目前广泛应用的内镜活动评价指标。本研究旨在阐明术前内镜下活动对IPAA术后眼袋炎发生的预测价值。方法：回顾性收集2008年1月至2020年1月间行IPAA治疗的UC患者资料。UCEIS和MES是基于两名独立的内窥镜医生的术前结肠镜检查结果。结果：共纳入102例患者，中位随访时间为5年（四分位间距为2-9年）。其中21.6%的患者发生了眼袋炎。与MES相比，UCEIS与囊炎疾病活动指数的相关性更强。UCEIS≥7的受试者工作特征（ROC）曲线面积为0.747，敏感性为68.2%，特异性为81.2%，优于MES 3的受试者工作特征曲线面积为0.679，敏感性为54.5%，特异性为81.2%。此外，我们发现UCEIS≥7是ipaa后膀胱炎的独立危险因素[优势比（OR）， 8.860；95% CI, 1.969-39.865, p < 0.001]，其风险高于MES 3 （OR, 5.200; 95% CI, 1.895-14.273; p = 0.001）。结论：溃疡性结肠炎内镜下严重程度指数预测IPAA术后小囊炎优于MES。术前UCEIS≥7的患者应考虑更早、更频繁地进行术后结肠镜检查，及早发现包囊炎的发生。
Background: Pouchitis is the most common long-term complication after ileal pouch–anal anastomosis (IPAA) in patients with ulcerative colitis (UC). Ulcerative colitis endoscopic index of severity (UCEIS) and Mayo endoscopic score (MES) are widely used indices to evaluate endoscopic activity. This study aimed to clarify the predictive value of preoperative endoscopic activity on the occurrence of pouchitis after IPAA. Methods: Data of patients with UC who underwent IPAA from January 2008 to January 2020 were collected retrospectively. UCEIS and MES were based on the preoperative colonoscopy findings of two independent endoscopists. Results: A total of 102 patients with a median follow-up of 5 (interquartile range, 2–9) years were included in the study. Among them, 21.6% developed pouchitis. Compared with MES, UCEIS had a stronger correlation with pouchitis disease activity index. UCEIS ≥ 7 had the most significant receiver-operating characteristic (ROC) curve area of 0.747 with a sensitivity of 68.2% and specificity of 81.2% in predicting pouchitis, which outperformed MES of 3 with an ROC area of 0.679 with a sensitivity of 54.5% and specificity of 81.2%. Furthermore, we found that UCEIS ≥ 7 was an independent risk factor for post-IPAA pouchitis [odds ratio (OR), 8.860; 95% CI, 1.969–39.865, p < 0.001] with a higher risk than MES of 3 (OR, 5.200; 95% CI, 1.895–14.273; p = 0.001). Conclusion: Ulcerative colitis endoscopic index of severity performed better in predicting pouchitis after IPAA than MES. Earlier and more frequent postoperative colonoscopic surveillance should be considered in patients with preoperative UCEIS ≥ 7 to detect the occurrence of pouchitis earlier.
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影响因子：
4.9
作者：
Ferrante, Marc;Declerck, Sarah;D'Hoore, Andre
通讯作者：
D'Hoore, Andre
影响因子：
9.8
作者：
Yamamoto, Takayuki;Shimoyama, Takahiro;Matsumoto, Koichi
通讯作者：
Matsumoto, Koichi
影响因子：
2.4
作者：
Marchioni Beery R;Kane S
通讯作者：
Kane S
影响因子：
8.9
作者：
SANDBORN, WJ;TREMAINE, WJ;PHILLIPS, SF
通讯作者：
PHILLIPS, SF
DOI：
10.1016/j.clinre.2012.04.012
发表时间：
2012-12-01
影响因子：
2.7
作者：
Kalkan, I. H.;Dagli, U.;Ulker, A.
通讯作者：
Ulker, A.