Complications after ileal pouch-anal anastomosis in Korean patients with ulcerative colitis

Table 1 Clinical characteristics of the patients and operations n (%)

Characterisitics
Sex
Male	28 (38.9)
Female	44 (61.1)
Age
≥ 40	47 (65.3)
< 40	25 (34.7)
BMI
≥ 25	10 (13.9)
< 25	62 (86.1)
Co-morbidity	21 (29.2)
Hypertension	12 (16.7)
Diabetes	5 (6.9)
Liver disease	4 (5.6)
Cerebrovascular disease	2 (2.8)
Idiopathic thrombocytopenic purpura	1 (1.4)
Disease extent
Left colon	18 (25.0)
Transverse colon	27 (37.5)
Whole colon	27 (37.5)
Operation
Elective	63 (95.8)
Emergent	9 (12.5)
Indications
Medical intractability	56 (77.8)
Dysplasia or malignancy	7 (9.7)
Fulminant colitis	5 (6.9)
Toxic megacolon	2 (2.8)
Massive bleeding	2 (2.8)
Anastomosis
Double stapling	69 (95.8)
Hand-sewing	3 (4.2)

BMI: Body mass index.

Table 2 Early complications after ileal-pouch anal anastomosis n (%)

Complications
Early complications	31 (43.1)
Pouch related	12 (16.7)
Pouch bleeding	6 (8.3)
Pelvic abscess	4 (5.6)
Anastomosis rupture	3 (4.2)
Pouch unrelated	26 (36.1)
Wound infection	13 (18.1)
Ileus	6 (8.3)
Intra-abdominal bleeding	6 (8.3)
Pneumonia	2 (2.8)
Deep vein thrombosis	2 (2.8)

Table 3 Complications related to ileostomy take-down n (%)

Complications
Complications at ileostomy take-down	17 (23.6)
Wound infection	9 (12.5)
Ileus	8 (11.1)
Enterocutaneous fistula	2 (2.8)
Intra-abdominal abscess	1 (1.4)
Cardiac problems	1 (1.4)

Table 4 Late complications after ileal-pouch anal anastomosis n (%)

Complications		Development(mo, median)
Late complications	27 (37.5)
Pouch related	21 (29.2)
Pouchitis	17 (23.6)	15
Pouch vaginal fistula	5 ( 6.9)	17
Perianal abscess or fistula	4 ( 5.6)	11
Anastomosis stricture	2 ( 2.8)	21.5
Pouch unrelated	12 (16.7)
Ileus	10 (13.9)	17
Incisional hernia	2 ( 2.8)	18.5

Table 5 Analysis of risk factors for pouch related complications and pouch failure

Variables	Early complication	Late complication	Pouch failure	P value (univariate)(early/late/failure)	P value (multivariate)(early/late)
Sex				0.755/0.249/0.518	/0.998
Male	4 (14.3)	6 (21.4)	0 (0.0)
Female	8 (18.2)	15 (34.1)	2 (4.5)
Age				0.524/0.140/1.000	/0.534
≥ 40	9 (19.1)	11 (23.4)	1 (2.1)
< 40	3 (12.0)	10 (40.0)	1 (4.0)
Overweight				1.000/0.713/1.000
BMI ≥ 25	1 (10.0)	2 (20.0)	0 (0.0)
BMI < 25	10 (17.7)	19 (30.6)	2 (3.2)
Co-morbidities				0.737/0.618/0.501
Yes	4 (19.0)	7 (33.3)	1 (4.8)
No	8 (15.7)	14 (27.5)	1 (2.0)
Disease extents				1.000/0.653/1.000
Lt colon	3 (16.7)	6 (33.3)	0 (0.0)
Beyond lt colon	9 (16.7)	15 (27.8)	2 (3.7)
Operation				0.005/1.000/1.000	0.002/
Emergent	5 (55.6)	2 (22.2)	0 (0.0)
Elective	7 (11.1)	19 (30.2)	2 (3.2)
Anastomosis				0.426/1.000/1.000
Double stapling	11 (15.9)	20 (29.0)	2 (2.9)
Hand sawing	1 (33.3)	1 (33.3)	0 (0.0)
Pouchitis				0.028/0.0021/0.419	0.016/0.0021
Yes	6 (35.3)	7 (41.2)1	1 (5.9)
No	6 (10.9)	4 (7.3)	1 (1.8)
Early complications				/0.095/1.000	/0.998
Yes		6 (50.0)	0 (0.0)
No		15 (25.0)	2 (3.3)
Late complications				/0.082
Yes			2 (9.5)
No			0 (0.0)

¹Analysis with late complications except for the pouchitis. BMI: Body mass index.