{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T10:47:06Z","timestamp":1788778026731,"version":"build-2803163510"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,3,23]],"date-time":"2024-03-23T00:00:00Z","timestamp":1711152000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K23DK127241-01A1"],"award-info":[{"award-number":["K23DK127241-01A1"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>To better inform the risk of cuffitis in patients with ulcerative colitis (UC), we aimed to identify its occurrence and associated precolectomy factors in a large multicenter cohort of patients who underwent restorative proctocolectomy (RPC) with stapled ileal pouch\u2013anal anastomosis (IPAA).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This study was a retrospective cohort analysis of individuals diagnosed with UC or indeterminate colitis who underwent RPC with IPAA for refractory disease or dysplasia at Mount Sinai Hospital or the University of Chicago followed by at least 1 pouchoscopy with report of the pouch\u2013anal anastomosis. The primary outcome was cuffitis defined as ulceration of the cuff as reported in each pouchoscopy report.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The pouch\u2013anal anastomosis was mentioned in the pouchoscopy reports of 674 patients, of whom 525 (77.9%) had a stapled anastomosis. Among these, cuffitis occurred in 313 (59.6%) patients a median of 1.51 (interquartile range 0.59-4.17) years after final surgical stage. On multivariable analysis, older age (hazard ratio [HR], 1.01; 95% confidence interval [CI], 1.01-1.02), extensive disease (HR, 1.34; 95% CI, 1.01-1.78), exposure to biologics before colectomy (HR, 2.51; 95% CI, 1.93-3.27), and exposure to at least 2 or more biologics before colectomy (HR, 2.18; 95% CI, 1.40-3.39) were significantly associated with subsequent cuffitis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In this multicenter study of patients who underwent RPC with stapled IPAA and at least 1 follow-up pouchoscopy, cuffitis occurred in approximately 60% and was significantly associated with extensive disease and exposure to multiple biologics precolectomy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ibd\/izae029","type":"journal-article","created":{"date-parts":[[2024,3,23]],"date-time":"2024-03-23T21:48:54Z","timestamp":1711230534000},"page":"72-76","source":"Crossref","is-referenced-by-count":3,"title":["Extensive Disease and Exposure to Multiple Biologics Precolectomy Is Associated with Endoscopic Cuffitis Post\u2013Ileal Pouch\u2013Anal Anastomosis in Patients With Ulcerative Colitis"],"prefix":"10.1093","volume":"31","author":[{"given":"Hannah","family":"Posner","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai , New York, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Lombard","sequence":"additional","affiliation":[{"name":"University of Chicago Inflammatory Bowel Disease Center , Chicago, Illinois ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shintaro","family":"Akiyama","sequence":"additional","affiliation":[{"name":"University of Chicago Inflammatory Bowel Disease Center , Chicago, Illinois ,","place":["USA"]},{"name":"Department of Gastroenterology, Institute of Medicine, University of Tsukuba , Ibaraki ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathaniel A","family":"Cohen","sequence":"additional","affiliation":[{"name":"University of Chicago Inflammatory Bowel Disease Center , Chicago, Illinois ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David T","family":"Rubin","sequence":"additional","affiliation":[{"name":"University of Chicago Inflammatory Bowel Disease Center , Chicago, Illinois ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4968-5795","authenticated-orcid":false,"given":"Marla C","family":"Dubinsky","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai , New York, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sushila","family":"Dalal","sequence":"additional","affiliation":[{"name":"University of Chicago Inflammatory Bowel Disease Center , Chicago, Illinois ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9640-950X","authenticated-orcid":false,"given":"Maia","family":"Kayal","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai , New York, New York 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and hand-sewn ileal pouch-anal anastomosis for ulcerative colitis and familial adenomatous polyposis","volume":"25","author":"Fukui","year":"2023","journal-title":"Colorectal Dis."},{"issue":"7","key":"2025092823215599300_CIT0004","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.1093\/ibd\/izz227","article-title":"Inflammatory pouch conditions are common after ileal pouch anal anastomosis in ulcerative colitis patients","volume":"26","author":"Kayal","year":"2020","journal-title":"Inflamm Bowel Dis."},{"issue":"2","key":"2025092823215599300_CIT0005","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1097\/MIB.0b013e31828100ed","article-title":"Clinical course of cuffitis in ulcerative colitis patients with restorative proctocolectomy and ileal pouch-anal anastomoses","volume":"19","author":"Wu","year":"2013","journal-title":"Inflamm Bowel Dis."},{"issue":"S1","key":"2025092823215599300_CIT0006","doi-asserted-by":"crossref","first-page":"S85","DOI":"10.1097\/DCR.0000000000002593","article-title":"Diagnosis and management of cuffitis: a systematic review","volume":"65","author":"Hembree","year":"2022","journal-title":"Dis Colon Rectum."},{"issue":"12","key":"2025092823215599300_CIT0007","doi-asserted-by":"crossref","first-page":"1907","DOI":"10.1093\/ibd\/izad039","article-title":"Acute severe ulcerative colitis is associated with an increased risk of acute pouchitis","volume":"29","author":"Kayal","year":"2023","journal-title":"Inflamm Bowel Dis."},{"issue":"9","key":"2025092823215599300_CIT0008","doi-asserted-by":"crossref","first-page":"2416","DOI":"10.1111\/codi.15772","article-title":"Antitumour necrosis factor therapy is associated with de novo Crohn\u2019s disease after ileal pouch-anal anastomosis","volume":"23","author":"Truong","year":"2021","journal-title":"Colorectal Dis."},{"issue":"7","key":"2025092823215599300_CIT0009","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.1111\/codi.16589","article-title":"Predictors of pouch failure: a tertiary care inflammatory bowel disease centre experience","volume":"25","author":"Ricardo","year":"2023","journal-title":"Colorectal Dis."},{"issue":"9","key":"2025092823215599300_CIT0010","doi-asserted-by":"crossref","first-page":"1730","DOI":"10.1007\/s00595-014-0974-5","article-title":"Treatment strategy for preventing pouchitis as a postoperative complication of ulcerative colitis: the significance of the management of cuffitis","volume":"44","author":"Hashimoto","year":"2014","journal-title":"Surg Today."},{"issue":"9","key":"2025092823215599300_CIT0011","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1016\/S2468-1253(22)00039-5","article-title":"Management of pouch neoplasia: consensus guidelines from the International Ileal Pouch 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