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World J Surg Proced. Mar 28, 2015; 5(1): 119-126
Published online Mar 28, 2015. doi: 10.5412/wjsp.v5.i1.119
Ileo-anal pouch excision: A review of indications and outcomes
Caroline Mary Byrne, Paul Stephen Rooney
Caroline Mary Byrne, Paul Stephen Rooney, Department of Surgery, Royal Liverpool and Broadgreen University Hospitals NHS Trust, L7 8XP Liverpool, United Kingdom
Author contributions: Both authors contributed to this work.
Conflict-of-interest: None.
Correspondence to: Paul Stephen Rooney, Consultant General and Colorectal Surgeon, Department of Surgery, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Prescot Street, L7 8XP Liverpool, United Kingdom. paul.rooney@rlbuht.nhs.uk
Telephone: +44-151-7063426 Fax: +44-151-7063480
Received: September 28, 2014
Peer-review started: September 28, 2014
First decision: November 14, 2014
Revised: January 12, 2015
Accepted: January 30, 2015
Article in press: February 2, 2015
Published online: March 28, 2015
Processing time: 186 Days and 15.1 Hours
Core Tip

Core tip: There is currently no single paper in the literature that consolidates the indications for ileo-anal pouch excision and the subsequent outcomes.Reported overall excision rates vary and in this review ranged from 0.93% to 12.8%. Age and lower institutional volume (< 3.3 cases) were independent predictors of pouch failure; however surgeon case load was not.Main reasons identified for excision are sepsis (early), Crohn’s disease and poor functional outcomes (both late causes). Pouch cancers in ulcerative colitis and familial adenomatous polyposis are rare but 135 cases exist in the literature. An awareness of the technical pitfalls and complications that can occur should be fully appreciated.