Found this study and thought it might be really useful for anyone out there considering a J Pouch... The study was to try to find a way to quantify risk but there are a bunch of interesting findings throughout.. Like all studies they can be ridiculed and judged but I think this is a pretty good one. Also came out of CC so gets a few extra points from me there.
No doubt the more educated we (the patient) is, the better decisions we can make for our own health.
For those who aren't good at sifting through journal articles here are some summary points from this study.
* The study was taken between 1983 and 2001
* 1965 patients were involved in the study
* Of the 1,965 patients, 38 patients (1.9%) required pouch excision.
* The number of pouches failing decreased significantly over time, In the 1980s the failure rate was around 15%. In the 1990s it dropped down to about 4%. In the last 5 years it has been approximately 2%
* Prior to 1987, the majority of pelvic pouches (99%) were handsewn in contrast to the period from 1987 to 2001 whereby 91.1% of ileal pouches were stapled.
* the most important determinant for pouch failure was the formation of pouch-perineal or pouch-vaginal fistulae, often preceded by pelvic or perineal sepsis
* the diagnosis of Crohn disease was associated with a 9-fold increase in the likelihood of pouch failure
* A meta-analysis of over 8500 patients that have undergone ileoanal surgery over the last 20 years in 20 major centers around the country suggested that the overall worldwide pouch failure rate was about 6%. However, if 1 focuses on reports from the last 5 years, the failure rate has dropped considerably, down closer to 2%.
* The major causes of failure were associated either directly with Crohn’s disease or with suspected Crohn’s-associated complications, including fistulas, perianal sepsis, sinus tracts, etc
Article found here..
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1360119/
Cheers,
James
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