{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T10:01:16Z","timestamp":1770717676526,"version":"3.49.0"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2005,6,30]],"date-time":"2005-06-30T00:00:00Z","timestamp":1120089600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2005,9,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Pouch-related fistula occurs in 5\u201310 per cent of patients after restorative proctocolectomy. The present study identified risk factors associated with the development of such fistulas.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Data on preoperative and postoperative risk factors were recorded from 1965 patients who underwent restorative proctocolectomy in a single tertiary centre between 1983 and 2001. Cox regression analysis was used to identify independent predictors of pouch\u2013perineal, pouch\u2013abdominal wall and pouch\u2013vaginal fistula during follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Median patient follow-up was 4\u00b71 (range 0\u201319) years. By 15 years' follow-up, pouch\u2013vaginal fistulas had occurred in 44 women (5\u00b72 per cent). The prevalence of ileal pouch\u2013perineal and pouch\u2013abdominal wall fistula was 3\u00b76 per cent (70 patients) and 1\u00b75 per cent (30 patients) respectively. Independent predictors of pouch-related fistula identified by multivariate analysis were diagnosis of indeterminate colitis or Crohn's disease (hazard ratio (HR) 1\u00b728 (95 per cent confidence interval (c.i.) 1\u00b700 to 1\u00b765) and 1\u00b773 (95 per cent c.i. 1\u00b707 to 3\u00b748) respectively versus ulcerative colitis or familial adenomatous polyposis), previous anal pathology (HR 3\u00b743 (95 per cent c.i. 2\u00b743 to 4\u00b784) and 4\u00b702 (95 per cent c.i. 1\u00b727 to 12\u00b777) respectively for perineal abscess and fistula in ano versus no previous anal pathology), abnormal anal manometry (HR 4\u00b729 (95 per cent c.i. 2\u00b733 to 7\u00b791)), patient sex (HR 0\u00b774 (95 per cent c.i. 0\u00b758 to 0\u00b795) for men versus women) and pelvic sepsis (HR 3\u00b779 (95 per cent c.i. 2\u00b748 to 5\u00b779)).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This study suggests that Crohn's disease and the clinical signs that favour the diagnosis of Crohn's disease may contribute to the development of pouch-related fistula.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.5071","type":"journal-article","created":{"date-parts":[[2005,6,30]],"date-time":"2005-06-30T11:48:46Z","timestamp":1120132126000},"page":"1270-1276","source":"Crossref","is-referenced-by-count":62,"title":["Risk factors associated with ileal pouch-related fistula following restorative proctocolectomy"],"prefix":"10.1093","volume":"92","author":[{"given":"P P","family":"Tekkis","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA"},{"name":"Imperial College London, Department of Surgical Technology and Oncology, St Mary's Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V W","family":"Fazio","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F","family":"Remzi","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A G","family":"Heriot","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA"},{"name":"Imperial College London, Department of Surgical Technology and Oncology, St Mary's Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E","family":"Manilich","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S A","family":"Strong","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2005,6,30]]},"reference":[{"key":"2021070906200172100_bib1","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1007\/BF02987076","article-title":"Total colectomy, mucosal proctectomy, and ileoanal anastomosis","volume":"23","author":"Utsunomiya","year":"1980","journal-title":"Dis Colon Rectum"},{"key":"2021070906200172100_bib2","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1002\/bjs.1800740705","article-title":"Restorative proctocolectomy: the four loop (W) reservoir","volume":"74","author":"Nicholls","year":"1987","journal-title":"Br J Surg"},{"key":"2021070906200172100_bib3","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1097\/01.sla.0000090940.39838.6a","article-title":"Quantification of risk for pouch failure after ileal pouch anal anastomosis surgery","volume":"238","author":"Fazio","year":"2003","journal-title":"Ann Surg"},{"key":"2021070906200172100_bib4","first-page":"80","article-title":"Problems after ileo-pouch anal anastomosis for ulcerative colitis. 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