{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T22:55:01Z","timestamp":1785884101150,"version":"3.56.0"},"reference-count":57,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clin Colon Rectal Surg"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Up to 30% of patients with ulcerative colitis will ultimately require surgery. Generally, surgery for ulcerative colitis consists of total proctocolectomy with either end ileostomy or ileal pouch anal anastomosis, which may be performed in 1 to 3 stages. There are risks and benefits specific to undergoing permanent ileostomy creation or ileal pouch anal anastomosis, with each procedure resulting in different and dramatic changes in a patient's day-to-day life. Because most patients are eligible for either procedure, patient preferences are an important consideration when creating a treatment plan. Shared decision-making is a collaborative process where surgeons and patients work together to make a treatment decision that is evidence-based and incorporates patient values. Here, we review the differences between end ileostomy and ileal pouch anal anastomosis, focusing on the risks and lifestyle considerations that may inform treatment decisions, as well as the available tools to support shared decision-making during surgical consultations.<\/jats:p>","DOI":"10.1055\/a-2760-7039","type":"journal-article","created":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T00:04:56Z","timestamp":1766534696000},"page":"337-342","source":"Crossref","is-referenced-by-count":0,"title":["Ileostomy or Ileal Pouch Anal Anastomosis: Shared Decision-Making in the Surgical Management of Ulcerative Colitis"],"prefix":"10.1055","volume":"39","author":[{"given":"Brian T.","family":"Cain","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery, University of Utah, Salt Lake City, Utah, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica N.","family":"Cohan","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Department of Surgery, University of Utah, Salt Lake City, Utah, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,12,23]]},"reference":[{"issue":"07","key":"ref1","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1093\/ecco-jcc\/jjy040","article-title":"Colectomy rates in ulcerative colitis are low and decreasing: 10-year follow-up data from the Swiss IBD cohort study","volume":"12","author":"L Parragi","year":"2018","journal-title":"J Crohns Colitis"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1097\/DCR.0000000000000030","article-title":"Practice parameters for the surgical treatment of ulcerative colitis","volume":"57","author":"H Ross","year":"2014","journal-title":"Dis Colon Rectum"},{"issue":"10","key":"ref3","doi-asserted-by":"crossref","first-page":"2031","DOI":"10.1016\/j.cgh.2020.10.039","article-title":"Contemporary risk of surgery in patients with ulcerative colitis and Crohn's disease: a meta-analysis of population-based cohorts","volume":"19","author":"L Tsai","year":"2021","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"6130","key":"ref4","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1136\/bmj.2.6130.85","article-title":"Proctocolectomy without ileostomy for ulcerative colitis","volume":"2","author":"A G Parks","year":"1978","journal-title":"BMJ"},{"issue":"02","key":"ref5","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1001\/archsurg.1969.01340140095014","article-title":"Intra-abdominal \u201creservoir\u201d in patients with permanent ileostomy. Preliminary observations on a procedure resulting in fecal \u201ccontinence\u201d in five ileostomy patients","volume":"99","author":"N G Kock","year":"1969","journal-title":"Arch Surg"},{"issue":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.suc.2012.09.004","article-title":"Considerations and complications in patients undergoing ileal pouch anal anastomosis","volume":"93","author":"T D Francone","year":"2013","journal-title":"Surg Clin North Am"},{"issue":"01","key":"ref7","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1177\/1457496919900409","article-title":"Restorative proctocolectomy in ulcerative colitis: effect of preoperative immunomodulatory therapy on postoperative complications and pouch failure","volume":"110","author":"E K Karjalainen","year":"2021","journal-title":"Scand J Surg"},{"issue":"03","key":"ref8","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1007\/DCR.0b013e31819ad4f2","article-title":"Outcomes for 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Comparison of performance status","volume":"209","author":"J H Pemberton","year":"1989","journal-title":"Ann Surg"},{"issue":"07","key":"ref35","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1002\/bjs.4220","article-title":"Parastomal hernia","volume":"90","author":"P W Carne","year":"2003","journal-title":"Br J Surg"},{"issue":"07","key":"ref36","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1097\/DCR.0000000000002037","article-title":"The American Society of Colon and Rectal Surgeons clinical practice guidelines for the surgical management of ulcerative colitis","volume":"64","author":"S D Holubar","year":"2021","journal-title":"Dis Colon Rectum"},{"issue":"01","key":"ref37","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1111\/codi.15301","article-title":"A systematic review and meta-analysis of outcomes after elective surgery for ulcerative colitis","volume":"23","author":"D M Baker","year":"2021","journal-title":"Colorectal 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Dis"},{"issue":"05","key":"ref44","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1111\/j.1463-1318.2010.02538.x","article-title":"Quality of life, health-related quality of life and health status in patients having restorative proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis: a systematic review","volume":"14","author":"J T Heikens","year":"2012","journal-title":"Colorectal Dis"},{"issue":"11","key":"ref45","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1097\/DCR.0b013e3182690870","article-title":"A comparison of the quality of life of ulcerative colitis patients after IPAA vs ileostomy","volume":"55","author":"K Kuruvilla","year":"2012","journal-title":"Dis Colon Rectum"},{"issue":"09","key":"ref46","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1097\/DCR.0000000000000418","article-title":"Quality of life after total proctocolectomy with ileostomy or IPAA: a systematic review","volume":"58","author":"P B Murphy","year":"2015","journal-title":"Dis Colon Rectum"},{"issue":"02","key":"ref47","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1007\/BF02213889","article-title":"Comparison of postoperative satisfaction between ulcerative colitis patients who chose to undergo either a pouch or an ileostomy operation","volume":"1","author":"A Liddell","year":"1995","journal-title":"Int J Rehabil Health"},{"issue":"04","key":"ref48","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/S0002-9610(02)01424-1","article-title":"A longitudinal study of long-term quality of life after ileal pouch-anal anastomosis","volume":"185","author":"R M Weinryb","year":"2003","journal-title":"Am J Surg"},{"issue":"01","key":"ref49","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1186\/s12876-021-01916-0","article-title":"Ileostomy or ileal pouch-anal anastomosis for ulcerative colitis: patient participation and decisional needs","volume":"21","author":"J N Cohan","year":"2021","journal-title":"BMC Gastroenterol"},{"issue":"01","key":"ref50","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1093\/ibd\/izx026","article-title":"The informational needs and preferences of patients considering surgery for ulcerative colitis: results of a qualitative study","volume":"24","author":"D M Baker","year":"2017","journal-title":"Inflamm Bowel Dis"},{"issue":"07","key":"ref51","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1097\/DCR.0b013e318251e004","article-title":"Timing of restorative proctocolectomy in patients with medically refractory ulcerative colitis: the patient's point of view","volume":"55","author":"P A Neumann","year":"2012","journal-title":"Dis Colon Rectum"},{"issue":"04","key":"ref52","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1111\/codi.12538","article-title":"Patient and clinician preferences for surgical and medical treatment options in ulcerative colitis","volume":"16","author":"C M Byrne","year":"2014","journal-title":"Colorectal Dis"},{"issue":"05","key":"ref53","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1097\/SLA.0b013e3182864fd6","article-title":"Decision aids for patients facing a surgical treatment decision: a systematic review and meta-analysis","volume":"257","author":"A M Knops","year":"2013","journal-title":"Ann Surg"},{"issue":"01","key":"ref54","first-page":"CD001431","article-title":"Decision aids for people facing health treatment or screening decisions","volume":"1","author":"D Stacey","year":"2024","journal-title":"Cochrane Database Syst Rev"},{"issue":"06","key":"ref55","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1097\/DCR.0000000000000572","article-title":"A novel decision aid for surgical patients with ulcerative colitis: results of a pilot study","volume":"59","author":"J N Cohan","year":"2016","journal-title":"Dis Colon 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