Staff Specialist, Clinical Associate Professor, Ph
Mark Bremholm Ellebæk
Department of Surgery
| Project management | ||
| Project status | Open | |
| Data collection dates | ||
| Start | 01.09.2020 | |
| End | 31.12.2030 | |
OUH Pouch Database
Short summary
Patients with ulcerative colitis (UC) or familiar adenomatous polyposis (FAP) may require excision of the colon and rectum if medical treatment fails. To restore fecal reservoir function and thus normal toilet visits, a pouch may be created from the end portion of the small intestine - an Ileo-Pouch Anal Anastomosis (IPAA). In most cases pouches are well functioning, but approximately 10% of patients have so severe complications that the pouch has to be removed (pouch failure).
Rationale
To obtain best possible outcome for ulcerative colitis patients undergoing IPAA continuous research of different variables needs exploring. 10% of pouch patients needs pouch removal because of complications and dysfunction and thus has to live with a permanent stoma for the rest of their days. Variables such as underlying Crohns diagnosis, anastomic leak, pelvic sepsis, low hospital expertise, post-surgical complications and pouch dysfunction have been established to increase the risk of pouch failure. Other variables such as omission of a diverting stoma does not impact pouch failure and some have yet to be investigated. To improve treatment of UC and FAP it is important to evaluate old and investigate new possible variables and how the diseases and the patients suffering from them. The aim of this study is therefore to assess the impact of rectal inflammation, pre-operative medication and endoscopic findings, post-surgical complications and long-term pouch dysfunctions on pouch survival.
Description of the cohort
From 1983 to present day there have been performed IPAA's on Odense University Hospital. Patients with UC operated between 1983 and 31-08-2020 have been logged in a retrospective database consisting of roughly 570 patients. From 01-09-2020 a prospective database of will be created to include patients with UC or FAP, ≥ 18 years old undergoing IPAA. Pouch creation because of other indications such as malignancy or Crohns disease will not be included.
Data and biological material
Information on included patients will be gathered from online patient records. Collected data will consist of basic demographic data such as age, sex and BMI, histopathologic examination of the resected colon, use of immunosuppressive medicine prior to IPAA, endoscopic findings and mayo score on examinations of the rectum/colon before IPAA, surgical strategy, post-operative complications primarily using the Clavien-Dindo classification and long term pouch complications such as stenosis and pouchitis.