Quantification of risk for pouch failure after ileal pouch anal anastomosis surgery.

摘要: Objective: To identify risk factors associated with ileal pouch failure and to develop a multifactorial model for quantifying the of in individual patients. Background Data: Ileal anal anastomosis (IPAA) has become treatment choice most patients ulcerative colitis familial adenomatous polyposis who require surgery. At present, there are no published studies that investigate collectively interrelation related failure, nor any predictive indices stratification undergoing IPAA Methods: Data from 23 preoperative, 7 intraoperative, 10 postoperative were recorded 1,965 restorative proctocolectomy single center between 1983 2001. Primary end point was during follow-up period up 19 years. The CCF developed using parametric survival analysis 70%:30% split-sample validation technique training testing. Results: median patient 4.1 year (range, 0-19 years). Five-year 95.6% (95% Cl, 94.4-96.7). following found be independent predictors used final multivariate model: diagnosis, prior pathology, abnormal manometry, comorbidity, pouch-perineal or pouch-vaginal fistulae, pelvic sepsis, anastomotic stricture separation. accurately predicted adequate calibration statistics (Hosmer Lemeshow X 2 = 3.001; P 0.557) an area under receiver operating characteristics curve 82.0%. Conclusions: is simple accurate way predicting clinical practice on longitudinal basis. It may play important role providing estimates wishing make informed choices type offered them.