{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T14:34:03Z","timestamp":1789569243919,"version":"build-2803163510"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T00:00:00Z","timestamp":1711584000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"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>Background<\/jats:title>\n                  <jats:p>Ileal pouch\u2013anal anastomosis is a technically demanding procedure with many potential complications. Rediversion with an ileostomy is often the first step in pouch salvage; however, it may not be clear if an individual patient will undergo subsequent pouch salvage surgery. We aimed to describe the indications and short- and long-term outcomes of rediversion in our pouch registry.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We queried our institutional pouch registry for patients who underwent index 2- or 3-stage IPAA and subsequent rediversion at our institution between 1985 and 2022. Pouches constructed elsewhere, rediverted elsewhere, or those patients who underwent pouch salvage\/excision without prior rediversion were excluded. Patients were selected for pouch salvage according to the surgeon\u2019s discretion.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Overall, 177 patients (3.4% of 5207 index pouches) were rediverted. At index pouch, median patient age was 32 years and 50.8% were women. Diagnoses included ulcerative colitis (86.4%), indeterminate colitis (6.2%), familial adenomatous polyposis (4.0%), and others (3.4%). Median time from prior ileostomy closure to rediversion was 7.2 years. Indications for rediversion were inflammatory in 98 (55.4%) and noninflammatory in 79 (44.6%) patients. After rediversion, 52% underwent pouch salvage, 30% had no further surgery, and 18.1% underwent pouch excision. The 5-year pouch survival rates for inflammatory and noninflammatory indications were 71.5% and 94.5%, respectively (P\u2005=\u2005.02).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Rediversion of ileoanal pouches is a safe initial strategy to manage failing pouches and is a useful first step in pouch salvage in many patients. Subsequent salvage surgery for noninflammatory indications had a significantly higher pouch salvage rate than those rediverted for inflammatory complications.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ibd\/izae061","type":"journal-article","created":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T16:29:46Z","timestamp":1711643386000},"page":"105-112","source":"Crossref","is-referenced-by-count":6,"title":["Rediversion of the Failing Ileoanal Pouch: First Step in Pouch Salvage?"],"prefix":"10.1093","volume":"31","author":[{"given":"Tairin","family":"Uchino","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery, Digestive Diseases Institute, Cleveland Clinic , Cleveland, OH ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eddy P","family":"Lincango","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Digestive Diseases Institute, Cleveland Clinic , Cleveland, OH ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar","family":"Hernandez Dominguez","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Digestive Diseases Institute, Cleveland Clinic , Cleveland, OH ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anuradha","family":"Bhama","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Digestive Diseases Institute, Cleveland Clinic , Cleveland, OH ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emre","family":"Gorgun","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Digestive Diseases Institute, Cleveland Clinic , Cleveland, OH ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arielle","family":"Kanters","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Digestive Diseases Institute, Cleveland Clinic , Cleveland, OH ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hermann","family":"Kessler","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Digestive Diseases Institute, Cleveland Clinic , Cleveland, OH ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Lipman","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Digestive Diseases Institute, Cleveland Clinic , Cleveland, OH ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Liska","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Digestive Diseases Institute, Cleveland Clinic , Cleveland, OH ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Sommovilla","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Digestive 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,","place":["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 Colorectal Surgery, Digestive Diseases Institute, Cleveland Clinic , Cleveland, OH ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,3,28]]},"reference":[{"issue":"7","key":"2025010605533361700_CIT0001","doi-asserted-by":"publisher","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":"Holubar","year":"2021","journal-title":"Dis Colon 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