Diagnosis and Management of Functional Pouch Disorders: A Systematic Review.
Dis Colon Rectum 2022;
65:S113-S118. [PMID:
36399771 DOI:
10.1097/dcr.0000000000002586]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND
Functional disorders impart significant morbidity in patients with inflammatory bowel disease who undergo restorative proctocolectomy.
OBJECTIVE
This systematic review aimed to summarize the management strategies for various functional disorders of the pouch.
DATA SOURCES
A database search of PubMed was conducted to identify relevant clinical studies assessing the management of various functional disorders in patients who underwent restorative proctocolectomy.
STUDY SELECTION
Published clinical studies investigating a functional disorder of the pouch in patients who previously underwent a colectomy with ileal pouch-anal anastomosis.
INTERVENTIONS
Restorative proctocolectomy was completed in patients with inflammatory bowel disease or other indications such as a diagnosis of familial adenomatous polyposis.
MAIN OUTCOME MEASURES
The primary outcomes described in this review include the prevalence of functional disorders of the pouch in patients undergoing restorative proctocolectomy and the relevant management strategies.
RESULTS
Ten clinical studies were identified using the predetermined search terms and screened for relevancy to patients with inflammatory bowel disease who previously underwent colectomy with ileal pouch-anal anastomosis. A qualitative summary was developed on the basis of data from these studies and from current guidelines developed for the management of inflammatory bowel disease.
LIMITATIONS
This systematic review is limited by the small number and low quality of the clinical studies included as well as the nonquantitative summary of the findings.
CONCLUSIONS
Functional disorders of the pouch are likely underdiagnosed. Although a source of significant morbidity, these diseases require additional clinical studies to better elucidate effective management strategies.
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