{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T03:00:06Z","timestamp":1768618806853,"version":"3.49.0"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,3,29]],"date-time":"2023-03-29T00:00:00Z","timestamp":1680048000000},"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":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Diverting loop ileostomy reversal (DLI\u2010R) is routinely performed from 2\u20136\u00a0months following ileal pouch\u2010anal anastomosis (IPAA). The safety of delayed reversal after IPAA is not well\u2010defined. The aim of this study was to determine if prolonged diversion is associated with adverse outcomes compared to routine closure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Adult patients undergoing primary IPAA with DLI from 2000 to 2021 were included in this retrospective cohort study from our institutional database. Patients were stratified into tertiles based on timing of reversal: Routine (56\u2013116\u2009days), Delayed (117\u2013180\u2009days), or Prolonged (&gt;6\u00a0months). Univariate analysis compared categorical variables between groups. Patients reversed at &lt;8\u2009weeks were excluded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 2615 patients underwent DLI\u2010R following IPAA (3\u2010stage 61%, 2\u2010stage 39%; mean age 39.9\u2009years). DLI\u2010R was performed as Routine, Delayed and Prolonged in 1908 (72.9%), 426 (16.4%) and 281 (10.8%), respectively. Overall, DLI\u2010R related complications occurred in 12.4% (<jats:italic>n<\/jats:italic>\u00a0=\u00a0324). The complication rate in the Routine group was 11% (<jats:italic>n<\/jats:italic>\u00a0=\u00a0210), in the Delayed group was 12.2% (<jats:italic>n<\/jats:italic>\u00a0=\u00a052) and in the Prolonged group was 22.1% (<jats:italic>n<\/jats:italic>\u00a0=\u00a062). Reasons for prolonged diversion in the Prolonged group were complications at the time of IPAA in 207 (73.9%) or patient preference\/scheduling in 73 (26.1%). DLI\u2010R\u2009&gt;6\u00a0months after IPAA due to complications had higher rates of overall complications following ileostomy reversal (OR 2.6, 95% CI 1.85\u20133.72, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) whereas when DLI\u2010R was delayed due to preference\/scheduling outcomes were not different than the Routine group (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.28).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Prolonged time to ileostomy reversal after IPAA is probably safe without increased risk of complications when due to patient preference.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.16560","type":"journal-article","created":{"date-parts":[[2023,3,30]],"date-time":"2023-03-30T05:18:03Z","timestamp":1680153483000},"page":"1187-1193","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Prolonged diversion after ileal pouch\u2010anal anastomosis: Is it safe to wait?"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6038-2563","authenticated-orcid":false,"given":"Cillian","family":"Clancy","sequence":"first","affiliation":[{"name":"Department of Colon and Rectal Surgery Digestive Disease and Surgery Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3178-7091","authenticated-orcid":false,"given":"Tara M.","family":"Connelly","sequence":"additional","affiliation":[{"name":"Department of Colon and Rectal Surgery Digestive Disease and Surgery Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xue","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Colon and Rectal Surgery Digestive Disease and Surgery Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremy","family":"Lipman","sequence":"additional","affiliation":[{"name":"Department of Colon and Rectal Surgery Digestive Disease and Surgery Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0459-0699","authenticated-orcid":false,"given":"Amy L.","family":"Lightner","sequence":"additional","affiliation":[{"name":"Department of Colon and Rectal Surgery Digestive Disease and Surgery Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tracy","family":"Hull","sequence":"additional","affiliation":[{"name":"Department of Colon and Rectal Surgery Digestive Disease and Surgery Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott R.","family":"Steele","sequence":"additional","affiliation":[{"name":"Department of Colon and Rectal Surgery Digestive Disease and Surgery Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2549-9042","authenticated-orcid":false,"given":"Stefan D.","family":"Holubar","sequence":"additional","affiliation":[{"name":"Department of Colon and Rectal Surgery Digestive Disease and Surgery Institute, Cleveland Clinic  Cleveland Ohio 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