{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:52:40Z","timestamp":1763599960331,"version":"3.40.5"},"reference-count":48,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,7,28]],"date-time":"2020-07-28T00:00:00Z","timestamp":1595894400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Ileal pouch\u2013anal anastomosis (IPAA) should be delayed to a second stage in patients with ulcerative colitis and prolonged exposure to medical therapy. However, there is still discussion about whether a modified two\u2010stage approach is preferable to a three\u2010stage approach. Recently, a transanal approach has been introduced to overcome the well\u2010known difficulties of laparoscopic pelvic surgery. This paper presents short\u2010term outcomes of transanal IPAA (Ta\u2010IPAA) according to a modified two\u2010stage approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data from all patients who underwent a modified two\u2010stage Ta\u2010IPAA for ulcerative colitis refractory to medical therapy were retrieved retrospectively from a prospective database. A comprehensive complication index was used for 90\u2010day postoperative complications. Conversion, duration of surgery, hospital stay and reoperation were considered. A logistic regression model was used to assess risk factors for peri\u2010pouch sepsis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventy\u2010five (68.8%) patients were identified from 109 consecutive IPAAs. Median operation time was 159\u00a0min. Conversion rate was 4%. Mean comprehensive complication index was 7. All anastomotic leaks (10.6%) were treated with diverting ileostomy. Additionally, active rescue with transanal drainage and early resuturing of the anastomotic gap was performed in six patients. Ileostomy closure occurred after a median period of 5.4\u00a0months. At univariable analysis, factors associated with peri\u2010pouch sepsis were male gender and age at IPAA construction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A modified two\u2010stage Ta\u2010IPAA is safe and feasible. Standardization and reproducibility of the technique are reflected in few conversions and intra\u2010operative complications. Finally, morbidity and anastomotic leak do not differ from those reported in previous Ta\u2010IPAA series with a variable proportion of multistage procedures.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.15231","type":"journal-article","created":{"date-parts":[[2020,7,3]],"date-time":"2020-07-03T21:00:57Z","timestamp":1593810057000},"page":"74-83","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Increasing experience of modified two\u2010stage transanal ileal pouch\u2013anal anastomosis for therapy refractory ulcerative colitis. What have we learned? A retrospective analysis on 75 consecutive cases at a tertiary referral hospital"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9212-9287","authenticated-orcid":false,"given":"G.","family":"Bislenghi","sequence":"first","affiliation":[{"name":"Department of Abdominal Surgery KU Leuven University Hospitals Leuven Leuven Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Martin\u2010Perez","sequence":"additional","affiliation":[{"name":"Department of Abdominal Surgery KU Leuven University Hospitals Leuven Leuven Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Fieuws","sequence":"additional","affiliation":[{"name":"Interuniversity Center for Biostatistics and Statistical Bioinformatics University of Leuven and University of Hasselt Leuven 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