Impact of the body mass index on the retention of the anorectal mucosa after double-stapled ileal pouch-anal anastomosis for ulcerative colitis
Abstract Background Double-stapled ileal pouch-anal anastomosis (DS-IPAA) is easy to construct and has a good functional outcome in patients with ulcerative colitis (UC). However, retention of the anorectal mucosa may lead to a subsequent risk of inflammation and neoplasia. This study aimed to ident...
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| Format: | Article |
| Language: | English |
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BMC
2023-02-01
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| Series: | BMC Gastroenterology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12876-023-02667-w |
| _version_ | 1811165859105734656 |
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| author | Hideaki Kimura Kenichiro Toritani Reiko Kunisaki Kenji Tatsumi Kazutaka Koganei Akira Sugita Itaru Endo |
| author_facet | Hideaki Kimura Kenichiro Toritani Reiko Kunisaki Kenji Tatsumi Kazutaka Koganei Akira Sugita Itaru Endo |
| author_sort | Hideaki Kimura |
| collection | DOAJ |
| description | Abstract Background Double-stapled ileal pouch-anal anastomosis (DS-IPAA) is easy to construct and has a good functional outcome in patients with ulcerative colitis (UC). However, retention of the anorectal mucosa may lead to a subsequent risk of inflammation and neoplasia. This study aimed to identify factors associated with the retention of a large amount of anorectal mucosa after DS-IPAA. Methods The medical records of 163 patients who had undergone one-stage total proctocolectomy and DS-IPAA for UC between 2007 and 2020 were retrospectively reviewed. The patients were divided into two groups according to the length of the retained mucosa. The high anastomosis group was defined as having a retained mucosal length of ≥ 30 mm in the anterior or posterior wall. Clinical factors were compared between the high and low anastomosis groups. Results The high anastomosis group showed a significantly higher body mass index (BMI) (high vs. low: 23.2 vs. 19.0), longer operation time (304 vs. 263) and greater blood loss (357 vs. 240). In the multivariate analysis, high BMI was the only factor significantly associated with high anastomosis (odds ratio 1.32). There was a positive correlation between BMI and the length of the retained mucosa. Conclusions In DS-IPAA, BMI showed the strongest association with the retention of a large amount of the anorectal mucosa. In high BMI patients, although the risk of inability of anastomosis is little than that of IPAA with mucosectomy, the possible retention of a large amount of mucosa should be considered. |
| first_indexed | 2024-04-10T15:44:21Z |
| format | Article |
| id | doaj.art-9106e2eddd704e75bc079a46479dbd3b |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-04-10T15:44:21Z |
| publishDate | 2023-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-9106e2eddd704e75bc079a46479dbd3b2023-02-12T12:13:46ZengBMCBMC Gastroenterology1471-230X2023-02-012311910.1186/s12876-023-02667-wImpact of the body mass index on the retention of the anorectal mucosa after double-stapled ileal pouch-anal anastomosis for ulcerative colitisHideaki Kimura0Kenichiro Toritani1Reiko Kunisaki2Kenji Tatsumi3Kazutaka Koganei4Akira Sugita5Itaru Endo6Inflammatory Bowel Disease Center, Yokohama City University Medical CenterInflammatory Bowel Disease Center, Yokohama City University Medical CenterInflammatory Bowel Disease Center, Yokohama City University Medical CenterInflammatory Bowel Disease Center, Yokohama Municipal Citizen’s HospitalInflammatory Bowel Disease Center, Yokohama Municipal Citizen’s HospitalInflammatory Bowel Disease Center, Yokohama Municipal Citizen’s HospitalGastroenterological Surgery, Yokohama City UniversityAbstract Background Double-stapled ileal pouch-anal anastomosis (DS-IPAA) is easy to construct and has a good functional outcome in patients with ulcerative colitis (UC). However, retention of the anorectal mucosa may lead to a subsequent risk of inflammation and neoplasia. This study aimed to identify factors associated with the retention of a large amount of anorectal mucosa after DS-IPAA. Methods The medical records of 163 patients who had undergone one-stage total proctocolectomy and DS-IPAA for UC between 2007 and 2020 were retrospectively reviewed. The patients were divided into two groups according to the length of the retained mucosa. The high anastomosis group was defined as having a retained mucosal length of ≥ 30 mm in the anterior or posterior wall. Clinical factors were compared between the high and low anastomosis groups. Results The high anastomosis group showed a significantly higher body mass index (BMI) (high vs. low: 23.2 vs. 19.0), longer operation time (304 vs. 263) and greater blood loss (357 vs. 240). In the multivariate analysis, high BMI was the only factor significantly associated with high anastomosis (odds ratio 1.32). There was a positive correlation between BMI and the length of the retained mucosa. Conclusions In DS-IPAA, BMI showed the strongest association with the retention of a large amount of the anorectal mucosa. In high BMI patients, although the risk of inability of anastomosis is little than that of IPAA with mucosectomy, the possible retention of a large amount of mucosa should be considered.https://doi.org/10.1186/s12876-023-02667-wBody mass indexDouble-stapled ileal pouch-anal anastomosisLength of the retained mucosaRetention of the anorectal mucosaUlcerative colitis |
| spellingShingle | Hideaki Kimura Kenichiro Toritani Reiko Kunisaki Kenji Tatsumi Kazutaka Koganei Akira Sugita Itaru Endo Impact of the body mass index on the retention of the anorectal mucosa after double-stapled ileal pouch-anal anastomosis for ulcerative colitis BMC Gastroenterology Body mass index Double-stapled ileal pouch-anal anastomosis Length of the retained mucosa Retention of the anorectal mucosa Ulcerative colitis |
| title | Impact of the body mass index on the retention of the anorectal mucosa after double-stapled ileal pouch-anal anastomosis for ulcerative colitis |
| title_full | Impact of the body mass index on the retention of the anorectal mucosa after double-stapled ileal pouch-anal anastomosis for ulcerative colitis |
| title_fullStr | Impact of the body mass index on the retention of the anorectal mucosa after double-stapled ileal pouch-anal anastomosis for ulcerative colitis |
| title_full_unstemmed | Impact of the body mass index on the retention of the anorectal mucosa after double-stapled ileal pouch-anal anastomosis for ulcerative colitis |
| title_short | Impact of the body mass index on the retention of the anorectal mucosa after double-stapled ileal pouch-anal anastomosis for ulcerative colitis |
| title_sort | impact of the body mass index on the retention of the anorectal mucosa after double stapled ileal pouch anal anastomosis for ulcerative colitis |
| topic | Body mass index Double-stapled ileal pouch-anal anastomosis Length of the retained mucosa Retention of the anorectal mucosa Ulcerative colitis |
| url | https://doi.org/10.1186/s12876-023-02667-w |
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