Original article—alimentary tractAntimicrobial Antibodies Are Associated With a Crohn's Disease–Like Phenotype After Ileal Pouch–Anal Anastomosis
Section snippets
Study Population
More than 1600 patients who had undergone IPAA before 2007 at Mount Sinai Hospital in Toronto, Canada, and who were registered in a Pelvic Pouch database were contacted to participate in the study, which was approved by the Research Ethics Board of Mount Sinai Hospital. All patients provided written informed consent.
Patients with a confirmed precolectomy diagnosis of UC who had a minimum of 2-year follow-up after ileostomy closure were eligible for the study. Patients with confirmed or
Results
One thousand four hundred twenty-seven patients from the Mount Sinai Hospital Pelvic Pouch Database were contacted, and 420 patients with a precolectomy diagnosis of UC were included and provided consent to participate in the study. Twenty-one patients were excluded after medical records review: 10 patients with familial adenomatous polyposis, 10 with a precolectomy diagnosis of indeterminate colitis or IBDU, and 1 because of a precolectomy diagnosis of microscopic colitis. The remaining 399
Discussion
The development of CP and a CDL phenotype of the pouch after IPAA for UC are among the greatest risk factors for pouch failure after surgery.7 A model to help identify UC patients at risk for complications after IPAA would be very useful when counseling patients in whom colectomy is a consideration for management. A number of studies have examined clinical risk factors as predictors of outcome demonstrating that smoking, family history of CD, and Ashkenazi Jewish ethnicity are associated with a
Acknowledgments
The authors would like to thank Diane Verbeeten and Lucy T. Zhang for their assistance with the study, and Harden Huang and Brenda O'Connor for maintaining and providing access to the Mount Sinai Hospital Pelvic Pouch Database.
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Conflicts of interest This author discloses the following: Dr Silverberg receives research support and consulting fees from Prometheus Laboratories. The remaining authors disclose no conflicts.
Funding Supported by Crohn's and Colitis Foundation of Canada, Zane Cohen Centre for Digestive Diseases.