{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T06:50:30Z","timestamp":1792651830783,"version":"4.5.0"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2021,2,5]],"date-time":"2021-02-05T00:00:00Z","timestamp":1612483200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100011684","name":"Crohn\u2019s & Colitis Foundation","doi-asserted-by":"crossref","award":["567497"],"award-info":[{"award-number":["567497"]}],"id":[{"id":"10.13039\/100011684","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,8,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The optimal restorative surgical management of patients with concomitant diagnoses of primary sclerosing cholangitis and ulcerative colitis [PSC-UC] who require colectomy is controversial, given that patients may have an increased risk for pouchitis after ileal pouch-anal anastomosis [IPAA]. We aimed to compare rates of pouchitis and pouch failure among patients with and without PSC by performing a systematic review and meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search performed through August 18, 2020, identified 12 studies that compared the rates of pouchitis [n\u2005=\u200511] and\/or pouch failure [n\u2005=\u20056] among patients with PSC-UC and UC alone. We then performed a meta-analysis using random effects modelling to estimate the odds of developing any episodes of pouchitis or pouch failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 4108 patients underwent an ileal pouch-anal anastomosis after proctocolectomy for UC. Of these, 3799 [92%] were performed for UC alone and 309 [8%] were performed for PSC-UC. In a meta-analysis of 11 studies, patients with PSC-UC compared with UC alone were significantly more likely to develop any pouchitis (63% vs 30%, odds ratio [OR] 4.21, 95% confidence interval [CI] 2.86\u20136.18), chronic pouchitis [47% vs 15%, OR 6.37, 95% CI 3.41\u201311.9], and pouch failure [10% vs 7%, OR 1.85, 95% CI 1.08\u20133.17].<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with PSC-UC were more likely to experience pouchitis and pouch failure than patients with UC alone. The risks of inflammatory complications after IPAA must be weighed against the potential complications with other surgical procedures, and future studies comparing outcomes among these procedures may inform decision making in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ecco-jcc\/jjab025","type":"journal-article","created":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T23:34:25Z","timestamp":1612308865000},"page":"1272-1278","source":"Crossref","is-referenced-by-count":42,"title":["Systematic Review and Meta-analysis of Outcomes After Ileal Pouch-anal Anastomosis in Primary Sclerosing Cholangitis and Ulcerative Colitis"],"prefix":"10.1093","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9894-8796","authenticated-orcid":false,"given":"Edward L","family":"Barnes","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA"},{"name":"Multidisciplinary Center for Inflammatory Bowel Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA"},{"name":"Center for Gastrointestinal Biology and Disease, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2549-9042","authenticated-orcid":false,"given":"Stefan D","family":"Holubar","sequence":"additional","affiliation":[{"name":"Department of Colon and Rectal Surgery, Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4268-823X","authenticated-orcid":false,"given":"Hans H","family":"Herfarth","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA"},{"name":"Multidisciplinary Center for Inflammatory Bowel Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA"},{"name":"Center for Gastrointestinal Biology and Disease, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,2,5]]},"reference":[{"key":"2021080318133031100_CIT0001","doi-asserted-by":"crossref","DOI":"10.1016\/j.cgh.2020.10.039","article-title":"Contemporary risk of surgery in patients with ulcerative colitis and Crohn\u2019s disease: a meta-analysis of population-based cohorts","author":"Tsai","year":"2020","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2021080318133031100_CIT0002","doi-asserted-by":"crossref","first-page":"1494","DOI":"10.1097\/DCR.0000000000001496","article-title":"Distinct disease phenotype of ulcerative colitis in patients with coincident primary sclerosing cholangitis: evidence from a large retrospective study with matched cohorts","volume":"62","author":"Cordes","year":"2019","journal-title":"Dis Colon Rectum"},{"key":"2021080318133031100_CIT0003","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1093\/ibd\/izz209","article-title":"Unique phenotypic characteristics and clinical course in patients with ulcerative colitis and primary sclerosing cholangitis: a multicenter US experience","volume":"26","author":"Wang","year":"2020","journal-title":"Inflamm Bowel Dis"},{"key":"2021080318133031100_CIT0004","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1016\/j.cgh.2018.01.023","article-title":"High risk of advanced colorectal neoplasia in patients with primary sclerosing cholangitis associated with inflammatory bowel disease","volume":"16","author":"Shah","year":"2018","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2021080318133031100_CIT0005","doi-asserted-by":"crossref","first-page":"1439","DOI":"10.14309\/ajg.0000000000000666","article-title":"An update on the medical management of inflammatory pouch complications","volume":"115","author":"Quinn","year":"2020","journal-title":"Am J Gastroenterol"},{"key":"2021080318133031100_CIT0006","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1080\/00365520310005938","article-title":"Patients with extraintestinal manifestations have a higher risk of developing pouchitis in ulcerative colitis: multivariate analysis","volume":"38","author":"Hata","year":"2009","journal-title":"Scand J Gastroenterol"},{"key":"2021080318133031100_CIT0007","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1093\/ibd\/izy267","article-title":"A comprehensive approach to pouch disorders","volume":"25","author":"Quinn","year":"2019","journal-title":"Inflamm Bowel Dis"},{"key":"2021080318133031100_CIT0008","first-page":"173","article-title":"The ileorectal anastomosis in ulcerative colitis. 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