{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T05:56:14Z","timestamp":1761630974056,"version":"3.37.3"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2021,11,18]],"date-time":"2021-11-18T00:00:00Z","timestamp":1637193600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Region Stockholm"},{"name":"Bengt Ihre research fellowship"},{"DOI":"10.13039\/501100009336","name":"Bengt Ihres Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009336","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Karolinska Institutet Foundations"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Restorative surgery after colectomy due to ulcerative colitis (UC) may be performed simultaneously with colectomy (primary) or as a staged procedure. Risk factors for failure after restorative surgery are not fully explored. This study aimed to compare the risk of failure after primary and staged reconstruction.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This is a national register-based cohort study of all patients 15 to 69 years old in Sweden treated with colectomy due to UC and who received an ileorectal anastomosis (IRA) or ileal pouch-anal anastomosis (IPAA) between 1997 and 2017. Failure was defined as a reoperation with new ileostomy after restorative surgery or a remaining defunctioning ileostomy after 2 years. Risk of failure was calculated using the Kaplan-Meier method and Cox regression adjusted for sex, age, calendar period, primary sclerosing cholangitis, and duration of UC.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 2172 included patients, 843 (38.8%) underwent primary reconstruction, and 1329 (61.2%) staged reconstruction. Staged reconstruction was associated with a decreased risk of failure compared with primary reconstruction (hazard ratio, 0.73; 95% CI, 0.58\u20130.91). The 10-year cumulative risk of failure was 15% vs 20% after staged and primary reconstruction, respectively. In all, 1141 patients (52.5%) received an IPAA and 1031 (47.5%) an IRA. In stratified multivariable models, staged reconstruction was more successful than primary reconstruction in both IRA (hazard ratio, 0.75; 95% CI, 0.54\u20131.04) and IPAA (hazard ratio, 0.73; 95% CI, 0.52\u20131.01), although risk estimates failed to attain statistical significance.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In UC patients undergoing colectomy, postponing restorative surgery may decrease the risk of failure.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ibd\/izab263","type":"journal-article","created":{"date-parts":[[2021,11,18]],"date-time":"2021-11-18T13:39:16Z","timestamp":1637242756000},"page":"1301-1308","source":"Crossref","is-referenced-by-count":4,"title":["Primary Versus Staged Reconstruction and Risk of Surgical Failure in Patients With Ulcerative Colitis: a Nation-wide Cohort Study"],"prefix":"10.1093","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3690-5349","authenticated-orcid":false,"given":"Karin","family":"Westberg","sequence":"first","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet and Division of Surgery , Danderyd Hospital, Stockholm , Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ola","family":"Ol\u00e9n","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet and Department of Pediatric Gastroenterology and Nutrition, Sachs\u2019 Children and Youth Hospital , Stockholm , Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonas","family":"S\u00f6derling","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet , Stockholm , Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonas","family":"Bengtsson","sequence":"additional","affiliation":[{"name":"Department of Surgery, Sahlgrenska University Hospital , Gothenburg , Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonas F","family":"Ludvigsson","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm and Department of Pediatrics, \u00d6rebro University Hospital , \u00d6rebro , Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c5sa H","family":"Everhov","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet and Department of Clinical Science and Education , S\u00f6dersjukhuset, Stockholm , Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P\u00e4r","family":"Myrelid","sequence":"additional","affiliation":[{"name":"Department of Surgery, Link\u00f6ping University Hospital and Department of Biomedical and Clinical Sciences, Faculty of Health, Link\u00f6ping University , Link\u00f6ping , Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline","family":"Nordenvall","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet and Department of Pelvic Cancer , Karolinska University Hospital, Stockholm , Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,11,18]]},"reference":[{"key":"2023112019092411100_CIT0001","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1053\/j.gastro.2017.10.034","article-title":"Incidence and treatment of patients diagnosed withinflammatory bowel diseases at 60 years or 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