{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T12:16:37Z","timestamp":1770207397811,"version":"3.49.0"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:00:00Z","timestamp":1765756800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Crohn\u2019s & Colitis Foundation Litwin Renewal","award":["974823"],"award-info":[{"award-number":["974823"]}]},{"name":"European Crohn\u2019s & Colitis Organization Research"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>The necessity of diverting loop-ileostomy after a staged ileoanal pouch for ulcerative colitis (UC) remains unclear. This study aimed to compare postoperative outcomes between modified-two-stage and three-stage ileoanal pouch procedures for UC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included patients \u226518\u2009years with UC or unclassified inflammatory bowel disease who underwent modified-two-stage or three-stage ileoanal pouch surgery from 2016 to 2021 in six European centers, with a follow-up of more than 12\u2009months. The primary outcome was stoma-free rate at the end of follow-up. Secondary outcomes included perioperative practise, length of hospital stay, anastomotic leakage rate, and timing of diagnosis and treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 370 patients were included, of whom 228 (61.6%) underwent a modified-two-stage approach and 142 (38.4%) a three-stage approach. The median length of follow-up was 3.6\u2009years (range: 1.0-7.7). Stoma-free rate was 93.8% (213\/227) in modified-two-stage patients and 91.5% (130\/142) in three-stage patients (P\u2009=\u2009.404). Notably, 78.4% of modified-two-stage patients never required an ileostomy, while the remaining 21.6% did receive a secondary ileostomy. While the median length of hospital stay for pouch surgery was longer in the modified-two-stage group, total median length of hospital stay after 1\u2009year was shorter (median 7.0\u2009days [IQR 6.0-11.0] vs 9.0\u2009days [IQR 7.0-12.5], P\u2009=\u2009.015). The Clavien\u2013Dindo score was higher than II in 22.6% of modified-two-stage patients and in 8.7% of three-stage patients (P\u2009&amp;lt;\u2009.001). Anastomotic leakage rate was higher after the modified-two-stage procedure (18% vs 5%, P\u2009&amp;lt;\u2009.001), but diagnosis and treatment occurred earlier (86% within 21\u2009days vs 43%, P\u2009=\u2009.009).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Both approaches have comparable high stoma-free rates at the end of follow-up. Modified-two-stage avoids a temporary stoma in more than 75% of patients, but has a significantly higher rate of anastomotic leakages. Active and early surveillance of the anastomosis after three-stage procedures could improve postoperative outcomes in this group.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ecco-jcc\/jjaf201","type":"journal-article","created":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T13:14:54Z","timestamp":1763558094000},"source":"Crossref","is-referenced-by-count":0,"title":["Modified-two-stage versus three-stage approach in ileoanal pouch surgery for ulcerative colitis"],"prefix":"10.1093","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-4948-8551","authenticated-orcid":false,"given":"Tycho B","family":"Moojen","sequence":"first","affiliation":[{"name":"Department of Surgery, Amsterdam University Medical Centre , Amsterdam,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malaika S","family":"Vlug","sequence":"additional","affiliation":[{"name":"Department of Surgery, Amsterdam University Medical Centre , Amsterdam,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1432-9606","authenticated-orcid":false,"given":"Eva","family":"Visser","sequence":"additional","affiliation":[{"name":"Department of Surgery, Amsterdam University Medical Centre , Amsterdam,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maud A","family":"Reijntjes","sequence":"additional","affiliation":[{"name":"Department of Surgery, Amsterdam University Medical Centre , Amsterdam,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johan F M","family":"Lange","sequence":"additional","affiliation":[{"name":"Department of Abdominal Surgery, University Medical Centre Groningen , Groningen,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9212-9287","authenticated-orcid":false,"given":"Gabriele","family":"Bislenghi","sequence":"additional","affiliation":[{"name":"Department of Abdominal Surgery, UZ Leuven , Leuven,","place":["Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Carvello","sequence":"additional","affiliation":[{"name":"IRCCS Humanitas Research Hospital , Rozzano, Milan, 20089,","place":["Italy"]},{"name":"Department of Biomedical Sciences, Humanitas University , Pieve Emanuele\u2014Milan, 20090,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7950-2833","authenticated-orcid":false,"given":"Janindra","family":"Warusavitarne","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, St Mark\u2019s Hospital , London,","place":["United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6094-8950","authenticated-orcid":false,"given":"Roel","family":"Hompes","sequence":"additional","affiliation":[{"name":"Department of Surgery, Amsterdam University Medical Centre , Amsterdam,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurents P S","family":"Stassen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Maastricht University Medical Centre , Maastricht,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar D","family":"Faiz","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, St Mark\u2019s Hospital , London,","place":["United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1493-1768","authenticated-orcid":false,"given":"Antonino","family":"Spinelli","sequence":"additional","affiliation":[{"name":"IRCCS Humanitas Research Hospital , Rozzano, Milan, 20089,","place":["Italy"]},{"name":"Department of Biomedical Sciences, Humanitas University , Pieve Emanuele\u2014Milan, 20090,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e9","family":"D\u2019Hoore","sequence":"additional","affiliation":[{"name":"Department of Abdominal Surgery, UZ Leuven , Leuven,","place":["Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Willem A","family":"Bemelman","sequence":"additional","affiliation":[{"name":"Department of Surgery, Amsterdam University Medical Centre , Amsterdam,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,12,15]]},"reference":[{"key":"2026020320065874400_jjaf201-B1","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1007\/BF01295733","article-title":"Clinical patterns, natural history, and progression of ulcerative colitis. 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