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Creation of an institutional preoperative checklist to support clinical risk assessment in patients with ulcerative colitis (UC) considering ileoanal pouch surgery.
Alves Martins, Bruno Augusto; Shamsiddinova, Amira; Alquaimi, Manal Mubarak; Worley, Guy; Tozer, Phil; Sahnan, Kapil; Perry-Woodford, Zarah; Hart, Ailsa; Arebi, Naila; Matharoo, Manmeet; Warusavitarne, Janindra; Faiz, Omar.
Afiliação
  • Alves Martins BA; Department of Colorectal Surgery, Hospital Universitário de Brasília, Brasilia, Brazil.
  • Shamsiddinova A; Department of Colorectal Surgery, St Mark's the National Bowel Hospital and Academic Institute, London, UK.
  • Alquaimi MM; Department of Colorectal Surgery, St Mark's the National Bowel Hospital and Academic Institute, London, UK.
  • Worley G; Department of Surgery and Cancer, Imperial College London, London, UK.
  • Tozer P; Department of Colorectal Surgery, St Mark's the National Bowel Hospital and Academic Institute, London, UK.
  • Sahnan K; Department of General Surgery, King Faisal University, Al-Hasa, Saudi Arabia.
  • Perry-Woodford Z; Department of Colorectal Surgery, St Mark's the National Bowel Hospital and Academic Institute, London, UK.
  • Hart A; Department of Colorectal Surgery, St Mark's the National Bowel Hospital and Academic Institute, London, UK.
  • Arebi N; Department of Surgery and Cancer, Imperial College London, London, UK.
  • Matharoo M; Department of Colorectal Surgery, St Mark's the National Bowel Hospital and Academic Institute, London, UK.
  • Warusavitarne J; Department of Surgery and Cancer, Imperial College London, London, UK.
  • Faiz O; Pouch and Stoma Care, St Mark's the National Bowel Hospital and Academic Institute, London, UK.
Frontline Gastroenterol ; 15(3): 203-213, 2024 May.
Article em En | MEDLINE | ID: mdl-38665796
ABSTRACT

Background:

Total proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the most established restorative operative approach for patients with ulcerative colitis. It has associated morbidity and the potential for major repercussions on quality of life. As such, patient selection is crucial to its success. The main aim of this paper is to present an institutional preoperative checklist to support clinical risk assessment and patient selection in those considering IPAA.

Methods:

A literature review was performed to identify the risk factors associated with surgical complications, decreased functional outcomes/quality of life, and pouch failure after IPAA. Based on this, a preliminary checklist was devised and modified through an iterative process. This was then evaluated by a consensus group comprising the pouch multidisciplinary team (MDT) core members.

Results:

The final preoperative checklist includes assessment for risk factors such as gender, advanced age, obesity, comorbidities, sphincteric impairment, Crohn's disease and pelvic radiation therapy. In addition, essential steps in the decision-making process, such as pouch nurse counselling and discussion regarding surgical alternatives, are also included. The last step of the checklist is discussion at a dedicated pouch-MDT.

Discussion:

A preoperative checklist may support clinicians with the selection of patients that are suitable for pouch surgery. It also serves as a useful tool to inform the discussion of cases at the MDT meeting.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Frontline Gastroenterol Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Frontline Gastroenterol Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido