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Characterization of megapouch in patients with restorative proctocolectomy

机译：恢复术治疗术患者Megapouch的特征

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BackgroundMegapouch is a rare functional complication of restorative proctocolectomy with ileal pouch-anal anastomosis characterized by pouchsmall bowel dilatation with no evidence of obstruction on endoscopy and imaging. Little is known about clinical characteristics and outcomes of this entity.MethodsWe included all patients diagnosed with megapouch at our institution, identified from a pouch database. Data on baseline characteristics, management, and outcomes were documented and analyzed from electronic medical records. Appropriate statistical measures were used. p<0.05 was considered significant.ResultsTwenty-three patients with megapouch were identified. The mean age was 40.7years; 95.6% had underlying ulcerative colitis; most common indication for colectomy was medically refractory disease (56.5%). Abdominal pain (82.6%) and bloating (52.2%) were most common presenting symptoms. Most common finding on pouchoscopy was pouch dilatation (81.8%), while barium or gastrografin enemas and MRI/CT mostly revealed dilatation of pouch and/or small bowel. Fourteen (66.7%) patients required some forms of surgerysix patients required pouch excision and three required either pouch redo or revision. Rates of pouch failure and IBD-related 1-year hospitalization were higher among patients managed surgically versus those managed medically (p=0.007 and 0.024, respectively), while need for escalation of IBD-therapy was comparable between the groups (p=0.133). No deaths were reported and no patient had recurrence of megapouch. IPAA revision or redo did not lead to more IBD-related morbidity.Conclusions Majority of our patients with megapouch required surgery. In selected patients, redo pouch offered cure. Rates of pouch failure and IBD-related 1-year hospitalization were higher among patients managed surgically.
机译：背景Megapouch是一种罕见的功能性并发症，其具有髂骨袋肛门吻合术，其特征在于囊袋肠膨胀，没有关于内窥镜检查和成像的阻塞的证据。关于这个实体的临床特征和结果，少许闻名。近奇途杂志包括诊断出在我们的机构患有Megapouch的所有患者，从囊数据库中确定。记录了基线特征，管理和结果的数据，并从电子医疗记录分析。使用适当的统计措施。 P <0.05被认为是显着的。鉴定了3种兆封术患者。平均年龄为40.7岁; 95.6％的溃疡性结肠炎潜水性;结肠切除术的最常见指示是医学上难治性疾病（56.5％）。腹痛（82.6％）和腹胀（52.2％）最常见的呈现症状。最常见的袋镜检查是袋扩张（81.8％），而钡或胃肠蛋白灌肠和MRI / CT主要揭示了袋子和/或小肠的扩张。十四（66.7％）患者需要某种形式的外科症患者需要袋子切除和三个需要袋子重做或修改。袋失败和与IBD相关的1年住院病的速率较高，患者与医学管理的患者（P = 0.007和0.024分别），而在组之间需要升级的升级（P = 0.133） 。没有报告任何死亡，没有患者的百万心复发。 IPAA修订或重做没有导致更多的IBD相关的发病率。结论我们的大多数患者伴随着兆大小的手术。在选定的患者中，Redo Pouch提供治疗。手术管理的患者患者中袋失效和IBD相关的1年住院病率较高。

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