Histopathological evaluation and risk factors related to the development of pouchitis in patients with ileal pouches for ulcerative colitis

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dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.author ARASHIRO, Roberta Thiery de Godoy FMUSP-HC
TEIXEIRA, Magaly Gemio FMUSP-HC
RAWET, Viviane
QUINTANILHA, Alina Guimaraes
PAULA, Henrique Moura de FMUSP-HC
SILVA, Adriano Zanon
NAHAS, Sergio Carlos FMUSP-HC
CECCONELLO, Ivan FMUSP-HC
dc.date.issued 2012
dc.identifier.citation CLINICS, v.67, n.7, p.705-710, 2012
dc.identifier.issn 1807-5932
dc.identifier.uri http://observatorio.fm.usp.br/handle/OPI/635
dc.description.abstract OBJECTIVE: Many changes in mucosal morphology are observed following ileal pouch construction, including colonic metaplasia and dysplasia. Additionally, one rare but potential complication is the development of adenocarcinoma of the reservoir. The aim of this study was to evaluate the most frequently observed histopathological changes in ileal pouches and to correlate these changes with potential risk factors for complications. METHODS: A total of 41 patients were enrolled in the study and divided into the following three groups: a non-pouchitis group (group 1) (n = 20; 8 males; mean age: 47.5 years) demonstrating optimal outcome; a pouchitis without antibiotics group (group 2) (n = 14; 4 males; mean age: 47 years), containing individuals with pouchitis who did not receive treatment with antibiotics; and a pouchitis plus antibiotics group (group 3) (n = 7; 3 males; mean age: 41 years), containing those patients with pouchitis who were administered antibiotics. Ileal pouch endoscopy was performed, and tissue biopsy samples were collected for histopathological analysis. RESULTS: Colonic metaplasia was found in 15 (36.6%) of the 41 patients evaluated; of these, five (25%) were from group 1, eight (57.1%) were from group 2, and two (28.6%) were from group 3. However, no correlation was established between the presence of metaplasia and pouchitis (p = 0.17). and no differences in mucosal atrophy or the degree of chronic or acute inflammation were observed between groups 1, 2, and 3 (p > 0.45). Moreover, no dysplasia or neoplastic changes were detected. However, the degree of mucosal atrophy correlated well with the time of postoperative follow-up (p = 0.05). CONCLUSIONS: The degree of mucosal atrophy, the presence of colonic metaplasia, and the degree of acute or chronic inflammation do not appear to constitute risk factors for the development of pouchitis. Moreover, we observed that longer postoperative follow-up times were associated with greater degrees of mucosal atrophy.
dc.language.iso eng
dc.publisher HOSPITAL CLINICAS, UNIV SAO PAULO
dc.relation.ispartof Clinics
dc.rights openAccess
dc.subject Colonic metaplasia; Atrophy; Ileal Pouch; Pouchitis; Proctocolectomy
dc.subject.other restorative proctocolectomy; anal anastomosis; pelvic pouch; extraintestinal manifestations; mucosal morphology; ileoanal pouch; adenocarcinoma; dysplasia; complication; inflammation
dc.title Histopathological evaluation and risk factors related to the development of pouchitis in patients with ileal pouches for ulcerative colitis
dc.type article
dc.rights.holder Copyright HOSPITAL CLINICAS, UNIV SAO PAULO
dc.description.group LIM/35
dc.identifier.doi 10.6061/clinics/2012(07)02
dc.identifier.pmid 22892912
dc.type.category original article
dc.type.version publishedVersion
hcfmusp.author ARASHIRO, Roberta Thiery de Godoy:FM:
hcfmusp.author TEIXEIRA, Magaly Gemio:HC:ICHC
hcfmusp.author PAULA, Henrique Moura de:FM:
hcfmusp.author NAHAS, Sergio Carlos:HC:ICHC
hcfmusp.author CECCONELLO, Ivan:FM:MGT
hcfmusp.author.external · RAWET, Viviane:Rawet Patol Especializada Ltda, Sao Paulo, Brazil
· QUINTANILHA, Alina Guimaraes:Univ Sao Paulo, Fac Med, Dept Gastroenterol, Serv Cirurgia Colon & Reto,Hosp Clin, Sao Paulo, Brazil
· SILVA, Adriano Zanon:Univ Sao Paulo, Fac Med, Dept Gastroenterol, Serv Cirurgia Colon & Reto,Hosp Clin, Sao Paulo, Brazil
hcfmusp.origem.id WOS:000307723100002
hcfmusp.origem.id 2-s2.0-84867039784
hcfmusp.origem.id SCIELO:S1807-59322012000700002
hcfmusp.publisher.city SAO PAULO
hcfmusp.publisher.country BRAZIL
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dc.description.index MEDLINE
hcfmusp.citation.scopus 4
hcfmusp.citation.wos 4
hcfmusp.affiliation.country Brasil


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