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Pouchitis may increase the risk of dysplasia after restorative proctocolectomy in patients with ulcerative colitis. 2012

T Banasiewicz, and R Marciniak, and J Paszkowski, and P Krokowicz, and E Kaczmarek, and J Walkowiak, and J Szmeja, and P Majewski, and M Drews
Department of General, Gastroenterological and Endocrinological Surgery, Poznan University of Medical Sciences, Poznań, Poland. tbanasiewicz@op.pl

OBJECTIVE Dysplasia of the pouch mucosa after restorative proctocolectomy is rare. The aim of this study was to establish whether there is a correlation between pouchitis and dysplasia. METHODS A group of 276 patients treated for ulcerative colitis by restorative proctocolectomy between 1984 and 2009 was analysed. The presence or absence of pouchitis and dysplasia within the pouch was evaluated. RESULTS Inflammation was diagnosed in 66 (23.9%) patients, low-grade dysplasia in five (1.8%), high-grade dysplasia in three (1.1%), and cancer in one patient (0.4%). The prevalence of low-grade dysplasia was significantly higher in patients with inflammation than in those without (P < 0.04). High-grade dysplasia was significantly more frequent in pouchitis than in non-inflamed pouches (P < 0.01). Logistic regression analysis suggested that the occurrence of mucosal inflammation increased the risk of low grade dysplasia. CONCLUSIONS Patients with chronic pouchitis are at risk of dysplasia and require surveillance of the pouch.

UI MeSH Term Description Entries
D008297 Male Males
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D011230 Precancerous Conditions Pathological conditions that tend eventually to become malignant. Preneoplastic Conditions,Condition, Preneoplastic,Conditions, Preneoplastic,Preneoplastic Condition,Condition, Precancerous,Conditions, Precancerous,Precancerous Condition
D003093 Colitis, Ulcerative Inflammation of the COLON that is predominantly confined to the MUCOSA. Its major symptoms include DIARRHEA, rectal BLEEDING, the passage of MUCUS, and ABDOMINAL PAIN. Colitis Gravis,Idiopathic Proctocolitis,Inflammatory Bowel Disease, Ulcerative Colitis Type,Ulcerative Colitis
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D001706 Biopsy Removal and pathologic examination of specimens from the living body. Biopsies
D012307 Risk Factors An aspect of personal behavior or lifestyle, environmental exposure, inborn or inherited characteristic, which, based on epidemiological evidence, is known to be associated with a health-related condition considered important to prevent. Health Correlates,Risk Factor Scores,Risk Scores,Social Risk Factors,Population at Risk,Populations at Risk,Correlates, Health,Factor, Risk,Factor, Social Risk,Factors, Social Risk,Risk Factor,Risk Factor Score,Risk Factor, Social,Risk Factors, Social,Risk Score,Score, Risk,Score, Risk Factor,Social Risk Factor
D012812 Sigmoidoscopy Endoscopic examination, therapy or surgery of the sigmoid flexure. Proctosigmoidoscopy,Sigmoidoscopic Surgical Procedures,Surgical Procedures, Sigmoidoscopic,Sigmoidoscopic Surgery,Surgery, Sigmoidoscopic,Procedure, Sigmoidoscopic Surgical,Procedures, Sigmoidoscopic Surgical,Proctosigmoidoscopies,Sigmoidoscopic Surgeries,Sigmoidoscopic Surgical Procedure,Sigmoidoscopies,Surgeries, Sigmoidoscopic,Surgical Procedure, Sigmoidoscopic

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