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Functional outcomes after transanal ileal pouch–anal anastomosis for ulcerative colitis: narrative review of the current literature

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Abstract

The transanal approach to ileal pouch–anal anastomosis (Ta-IPAA) for ulcerative colitis was introduced in 2015 and has since been shown to be a safe and feasible technique, although the impact of this approach on patient function remains unclear. A systematic literature review was performed to identify studies exploring functional outcomes and quality of life after Ta-IPAA. Seven papers were identified, which all demonstrated satisfactory functional outcomes after Ta-IPAA as measured by tools such as Cleveland Global Quality of Life (CGQOL), Oresland Score (OS), Pouch Functional Score (PFS), and Inflammatory Bowel Disease Questionnaire (IBDQ). Many gaps in the literature were identified including paucity of follow-up data beyond the 1-year mark, lack of fertility and fecundity assessment as functional outcomes, and limited evaluation of objective physiologic anal sphincter function. The Ta-IPAA therefore shows promise for good functional results in the short-term, although further research will be required to evaluate the stability of function over time as the technique becomes increasingly integrated into modern surgical practice.

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Authors and Affiliations

  1. Division of General Surgery, University of Toronto, Toronto, ON, Canada

    J. Vernon & D. Ng

  2. Department of Family Medicine, Western University, London, ON, Canada

    S. Khan

  3. Department of Medicine, University of Alberta, Edmonton, AB, Canada

    D. Koerber

  4. Division of General Surgery, St. Paul’s Hospital, University of British Columbia, Vancouver, BC, Canada

    A. Ghuman & A. Karimuddin

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Contributions

All authors contributed to the study design and execution. Design of the study question and systematic review were performed by DN, SK, and JV. The first draft of the manuscript was written by JV and all authors commented on prior versions. All authors read and approved of the final manuscript.

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Correspondence to J. Vernon.

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Vernon, J., Ng, D., Khan, S. et al. Functional outcomes after transanal ileal pouch–anal anastomosis for ulcerative colitis: narrative review of the current literature. Tech Coloproctol 27, 713–719 (2023). https://doi.org/10.1007/s10151-023-02798-y

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