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Original Article Appropriate J-pouch volume associated with improved clinical outcomes and long-term quality of life in patients with ulcerative colitis after ileal pouch-anal anastomosis: results from China UC Pouch Center Union
Weimin Xu1,2,*orcid, Zhujiang Dai1,2,*orcid, Wenjun Ding1,2,*orcid, Long Cui1,2orcid, Xiaojian Wu2,3orcid, Wei Zhou2,4orcid, Zhao Ding2,5orcid, Peng Du1,2orcid

DOI: https://doi.org/10.5217/ir.2026.00003
Published online: May 7, 2026

1Department of Colorectal Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

2China UC Pouch Center Union, Shanghai, China

3Department of Gastrointestinal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China

4Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China

5Department of Colorectal and Anal Surgery, Hubei Key Laboratory of Intestinal and Colorectal Diseases, Zhongnan Hospital of Wuhan University, Wuhan, China

Correspondence to Peng Du, Department of Colorectal Surgery, Xinhua Hospital,1665 Kongjiang Road, Shanghai 200092, China. E-mail: dupeng@xinhuamed.com.cn
Co-Correspondence to Weimin Xu, Department of Colorectal Surgery, Xinhua Hospital,1665 Kongjiang Road, Shanghai 200092, China. E-mail: xwmgodmin@163.com
*These authors contributed equally to this study as first authors.
• Received: January 4, 2026   • Revised: February 15, 2026   • Accepted: February 23, 2026

© 2026 Korean Association for the Study of Intestinal Diseases.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Background/Aims
    A well-functioning and well-constructed pouch is crucial for the long-term quality of life (QOL) in ulcerative colitis (UC) patients after ileal pouch-anal anastomosis (IPAA). What pouch volume is appropriate to construct to maintain satisfactory pouch function for better long-term prognosis remains unknown.
  • Methods
    UC patients who underwent IPAA from January 2008 to January 2024 in our pouch surgery centers affiliated with the China UC Pouch Center Union were enrolled. The primary outcomes were the occurrence of postoperative complications and impaired long-term QOL.
  • Results
    A total of 222 eligible UC patients with a median follow-up time of 8.0 years (interquartile range, 4.0–10.3 years) were enrolled. Among the patients, 117 (52.7%) had a pouch with volume <120 mL, whereas 105 (47.3%) had a pouch volume ≥120 mL. We found that patients with pouch volume ≥120 mL were more likely to achieve significantly improved long-term QOL (P=0.013), better bowel function (P=0.030) as well as have decreased risk of late postoperative complications (P=0.005), mainly presented as pouchitis (P=0.039). Furthermore, we demonstrated that a small pouch with volume < 120 mL is an independent risk factor for the development of late postoperative complications (odds ratio, 2.157; P=0.013) and impaired long-term QOL (odds ratio, 2.049; P=0.018).
  • Conclusions
    A J-pouch volume ≥120 mL could be a considerable option for colorectal surgeons in pouch configurations to achieve better long-term prognosis.
  • Keywords: Ulcerative colitis; Pouchitis; Quality of life; Postoperative complications
Total proctocolectomy with ileal pouch-anal anastomosis (IPAA), first proposed in 1978 [1], has been accepted as the radical surgery for ulcerative colitis (UC). Numerous pieces of evidence have demonstrated that IPAA can significantly improve long-term prognosis [2-4] as this surgical procedure removes the inflammatory colorectum as well as restores the intestinal continuity to prevent permanent ileostomy by creating an ileal reservoir, which is constructed from varying lengths of the distal ileum. However, IPAA is a complicated and technically demanding procedure, which is associated with several serious postoperative complications. Our previous studies indicated that intraoperative intravenous fluid administration and postoperative complications had detrimental effects on long-term quality of life (QOL) [5,6].
Among all pouch configurations, the J pouch is the most commonly used configuration due to its relatively easy construction and promising long-term outcomes [7,8]. The J pouch was joined, using varying methods, to the anorectal ring with sphincter conservation to recreate intestinal continuity and maintain normal physiology in IPAA. Thus, a well-functioning and well-constructed J pouch is decisive for the long-term QOL in UC patients after IPAA. Furthermore, appropriate pouch volume is crucial for a well-functioning J pouch as it is associated with bowel function after the operation. Although the volume is mainly determined by the length of ileum used for pouch creation [9], the radius of the transverse section of the terminal ileum and the compliance of the ileum itself also affect the volume. Thus, it is not accurate enough to determine the pouch volume only by detecting the pouch length. Our most recent study indicated that patients with a J-pouch length of 22±2 cm could achieve better clinical outcomes [10], but we ignored to analyze the effect of pouch volume on outcomes. Current evidence about the issue of what volume of pouch could make patients achieve the best long-term prognosis is lacking. Few studies with a long-term follow-up period comprehensively assess the relationship between pouch volume and clinical outcomes and long-term prognosis after IPAA.
In this study, we mainly aimed to explore whether pouch volume was associated with postoperative complications and long-term QOL and further determine the appropriate pouch volume for achieving better long-term prognosis, so as to provide clinicians with decision-making suggestions for pouch construction.
1. Patients and Study Design
A retrospective multicenter study with all UC patients who received IPAA from January 2008 to January 2024 in our 4 pouch surgery centers affiliated with the China UC Pouch Center Union was performed. Clinical data were retrospectively collected from hospital electronic medical records, and follow-up information was obtained from regular postoperative outpatient examination and questionnaire investigation regarding QOL improvement. In this study, patients diagnosed as UC with complete data were ultimately included for analysis, whereas those who underwent subtotal colectomy with permanent diverting ileostomy without pouch construction or had poor compliance with irregular follow-up and incomplete clinical data were excluded from this study. Our research protocol has been reviewed and approved by the Ethics Committee of Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine (No. XHEC-C-2024-187-1). The requirement for written informed consent was waived by the Ethics Committee.
2. Pouch Construction and Pouch Volume Measurement
As our institute is affiliated with the China UC Pouch Center Union, the procedure of IPAA is homogenized, standardized and performed by 3 experienced colorectal surgeons specialized in pouch surgery in each center. Briefly, after removing the affected colorectum, we used different numbers of endoscopic linear cutter reloads, by using a laparoscopic stapler, (Endo GIA60; Medtronic, Minneapolis, MN, USA), to construct a J pouch. The length of the cutting line of the side-to-side anastomosis of ileum was measured to record as the pouch length [10]. After the construction was completed, a 50-mL syringe was used to inject normal saline into the pouch until its maximum tolerated volume was reached to check for leak or bleeding at the anastomosis of the pouch body. The volume of injected normal saline was recorded intraoperatively as the pouch volume.
3. Clinical and Long-Term QOL Evaluation
The primary outcomes were the occurrence of postoperative complications and impaired long-term QOL improvement. Based on the Montreal classification system, we categorized UC as proctitis (E1), left-sided colitis (E2), and pancolitis (E3) according to the extent of affected colorectum [11]. Complications that developed within one month were considered early postoperative complications, whereas those that developed after one month were classified as late postoperative complications, mainly including pouchitis, postoperative late intestinal obstruction and anastomotic stricture. Wexner continence scores were measured to assess the bowel and defecation function. As we previously reported [5,10], the improvement of long-term QOL was evaluated by the difference between the pre-IPAA Cleveland Global Quality of Life (CGQL) instrument [12] after admission and the post-IPAA CGQL collected from the latest postoperative follow-up. Based on our previous research, the improvement percentage of CGQL of more than or less than 50% was considered as significantly improved long-term QOL or impaired long-term QOL in this study [5,10]. Briefly, the cumulative score of 3 items, current QOL (0–10 scores), current quality of health (0–10 scores), and current energy level (0–10 scores), was divided by 30 to obtain the ultimate CGQL scores.
4. Statistical Analysis
SPSS version 22.0 (IBM Corp., Armonk, NY, USA) and Graph Pad Prism 8.0 (San Diego, CA, USA) were used for statistical analysis. Continuous and categorical variables were presented as the mean and standard deviation and the median and interquartile range and analyzed by two-sample Student t-test and chi-square or Fisher exact test. Whereas the ranked data were analyzed using the Wilcoxon rank-sum test. Multivariate logistic regression analysis was performed to determine the risk factors for the development of late postoperative complications and impaired long-term QOL. The receiver-operating characteristic (ROC) curve was used to explore the best threshold evaluation for reflecting the long-term outcomes in J-pouch volume. The Kaplan-Meier method with the log-rank test was further performed to compare the overall late postoperative complications-free survival. The confidence interval (CI) was set at 95%. In this study, all statistics were two-sided, with a P-value <0.05 considered statistically significant.
1. Baseline Characteristics
A total of 239 UC patients who underwent IPAA in the China UC Pouch Center Union were initially enrolled. Of the patients, 8 patients were lost to follow-up and 9 patients with permanent diverting ileostomy without pouch construction were excluded. Thus, 222 eligible UC patients with complete data were ultimately included for further analysis (Fig. 1). Among the patients, the median follow-up time was 8.0 years (interquartile range, 4.0–10.3 years) and 117 patients (52.7%) had a pouch with volume <120 mL, whereas 105 patients (47.3%) received greater pouch construction with volume ≥120 mL (Table 1). In the whole cohort, most patients received IPAA due to medical treatment failure (86.9%) and a comparable proportion (5.4%) of patients who underwent IPAA due to malignant transformation. The detailed demographics and clinical characteristics are listed in Table 1.
2. Postoperative Complications
In the whole cohort, 59 patients (26.6%) developed the early postoperative complications, mainly presented as early postoperative intestinal obstruction (13.5%), pouch and anastomotic bleeding (5.0%), pouch-anal anastomotic leak (4.1%), wound infection (7.2%), and incisional hernia (1.4%). Whereas a total of 76 patients (34.2%) developed late postoperative complications. Among them, 61 (27.5%) developed pouchitis, 3 (1.4%) developed pouch failure, 11 (5.0%) had postoperative long-term intestinal obstruction, 4 (1.8%) underwent pouchvagina leak, 7 (3.2%) had anastomotic stricture and only 1 (0.5%) developed sexual dysfunction (Table 2).
3. Clinical Outcomes in Patients with J Pouch Configuration of Different Volume
To determine the best threshold value of J-pouch volume for reflecting the late complications, the ROC analysis was performed. As shown in Supplementary Fig. 1, pouch volume had the most significant area under the ROC curve (AUC) of 0.654 with a sensitivity of 56.9% and specificity of 73.9% at the cutoff value of 120 mL (P=0.002). Based on the above results, we chose a pouch volume of 120 mL as the cutoff value for further analysis. To this end, we compared the postoperative complications and long-term QOL in patients with J pouch configuration with a cutoff value of 120 mL. As shown in Table 3, patients with J-pouch volume ≥120 mL had a lower risk late postoperative complications (P=0.005), mainly presented as less pouchitis (P=0.039), less defecation frequency (P=0.001) and had better bowel function assessed by Wexner scores (P=0.030). To further explore whether pouch volume could affect the late postoperative complications-free survival, the Kaplan-Meier method with the log-rank test analysis was performed. As shown in Fig. 2, patients with pouch volume <120 mL were prone to have shorter overall late postoperative complications-free survival than patients whose pouch volume ≥120 mL (P=0.023).
Furthermore, we determined whether a pouch volume ≥120 mL contributed to significantly improved long-term QOL. To this end, we first demonstrated the obvious improvements of post-IPAA scores CGQL in both pouches with different volumes (Fig. 3A and B). Whereas the ultimate postoperative CGQL scores (0.731 vs. 0.773; P=0.015), the current QOL (7.145 vs. 7.657; P=0.018) and the current quality of health (7.188 vs. 7.600; P=0.043) more significantly improved in patients with pouch volume ≥120 mL (Table 3, Fig. 3C-F). Moreover, significantly improved long-term QOL was more common in patients with pouch volume ≥120 mL (Table 3). Collectively, these data indicated that pouch volume ≥120 mL was associated with a lower risk of late postoperative complications, better bowel function, and more significantly improved long-term QOL.
4. J-Pouch Volume <120 mL Increased the Risk of Late Postoperative Complications
Based on the above results, we speculated whether a pouch volume <120 mL could contribute to late postoperative complications. To this end, the univariate analysis was performed and the results indicated that J-pouch volume (P=0.005), the length of hospital stay (P=0.004), preoperative white blood cell counts (P=0.023), intraoperative blood loss (P=0.016), and operative duration (P=0.035) were associated with late postoperative complications (Table 4). Then these variables with significant differences in univariate analysis were further analyzed by the multivariate logistic regression. As shown in Table 5, J-pouch volume <120 mL (odds ratio [OR], 2.157; 95% CI, 1.175–3.960; P=0.013), preoperative white blood cell counts ≥10×109/L (OR, 2.205; 95% CI, 1.122–4.335; P=0.022) and operative duration ≥5 hours (OR, 1.927; 95% CI, 1.040–3.569; P=0.037) were independent risk factors for the development of late postoperative complications.
5. J-Pouch Volume <120 mL Affected the Improvement of Long-Term QOL
Next, we further explored whether J-pouch volume <120 mL contributed to the impaired long-term QOL. According to the results from the univariate analysis, age at diagnosis (P=0.045), surgical approach (P=0.001), J-pouch volume (P=0.013), preoperative level of albumin (P=0.030) and the length of hospital stay (P=0.017) were significantly associated with impaired long-term QOL (Table 6). Multivariate logistic regression further demonstrated that age at diagnosis ≥40 years old (OR, 1.977; 95% CI, 1.100–3.555; P=0.023), open surgery (OR, 2.590; 95% CI, 1.284–5.222; P=0.008), J-pouch volume <120 mL (OR, 2.049; 95% CI, 1.130–3.715; P=0.018), and preoperative albumin <35 g/L (OR, 2.310; 95% CI, 1.270–4.203; P=0.006) were contributing factors for impaired long-term QOL (Table 7).
Compared with the W and S pouches, the J pouch has become the most popular pouch configuration due to its technical simplicity and overall satisfactory functional characteristics [13]. Currently, a structured approach to the surgical procedure of pouch surgery is still indefinite, diversified and lack of consistent standards. What volume of pouch should be constructed to make patients achieve better benefits remains unclear. The present multicenter study with the largest sample size and longest follow-up period based on the China UC Pouch Center Union first explored the relationship between pouch volume and clinical outcomes after IPAA and determined the appropriate pouch volume for patients. Based on the results, we demonstrated that patients with the pouch volume ≥120 mL were more likely to achieve better long-term QOL and had a lower risk of late postoperative complications, mainly including reduced risk for pouchitis and better bowel function. Moreover, we indicated that relatively small pouch volume (<120 mL) could be an independent risk factor for the development of late postoperative complications and impaired long-term QOL. Thus, a J-pouch volume ≥120 mL could be a considerable option for colorectal surgeons in pouch configurations to make patients achieve better long-term prognosis.
The side-to-side anastomosis of the distal ileum is the critical step of pouch surgery. Although pouch volume is mainly determined by the length of side-to-side anastomosis of the pouch body, it does not mean a pouch with a longer length necessarily has a larger volume. The radius of the transverse section of the terminal ileum and the compliance of the ileum itself also determined the pouch volume. Thus, the measurement of pouch volume only by pouch length is inadequate. In addition, an appropriate pouch volume is closely associated with satisfactory pouch function. An excessively small pouch volume may compromise pouch compliance and function, resulting in increased stool frequency or even incontinence, thereby significantly affecting long-term QOL. Thus, constructing a pouch with an appropriate volume is important for colorectal surgeons to make patients achieve better long-term prognosis. However, the current evidence mainly focused on pouch length, few studies explored what pouch volume is appropriate for patients to achieve better long-term prognosis. We previously reported that patients with a pouch length of 22±2 cm had a lower risk of postoperative complications and more significantly improved long-term QOL than those with a pouch length of 14±2 cm [10]. In contrast, Miratashi Yazdi et al. [14] reported that patients with short J-pouch configuration (8±2 cm) were likely to obtain better postoperative QOL. Moreover, another study done by Shibata et al. [15] indicated that there was no significant correlation between J-pouch length and the functional outcome by the multivariate analysis. The inconsistency between pouch length and clinical outcomes reported in various studies further indicated that it is insufficient to assess outcomes only based on the pouch length. A previous randomized controlled trial reported that a 4-limb W pouch with greater maximum tolerated volume contributed to better bowel function and fewer nighttime defecations [16]. In the present study, we demonstrated that patients with J pouch of greater volume (≥120 mL) had less late postoperative complications, better bowel function, and long-term QOL, which provided supporting evidence for pouch configurations of greater pouch volume (≥120 mL) in UC patients with IPAA to make patients achieve better long-term prognosis.
Consistent with the previous study, pouchitis was the most common late complication after IPAA [10,17-20]. Pouchitis arises as a result of the complicated interactions between genetic factors, immune dysregulation and the imbalance in the gut microbiota [21]. The abundance of specific microbiota in patients with healthy pouch was different from patients with inflamed pouch [22-24]. Antibiotics and faecal microbiota transplantation were considered as the therapeutic strategies for pouchitis, which further provided plausibility that microbiota dysbiosis could affect the course of pouchitis [25,26]. Moreover, Machiels et al. [27] reported that an abundance of multiple intestinal gut microbiota before colectomy with IPAA was associated with the development of pouchitis, hence indicating that gut microbiota dysbiosis could influence the pouch function. Increased defecation frequency even incontinence could lead to the disruption of intestine homeostasis and further microbiota dysbiosis. A previous study also indicated that dysbiosis could be characterized as a directed alteration of the microbiome composition in patients with diarrhea-predominant irritable bowel syndrome [28]. Our previous studies reported pouches with short lengths contributed to more defecation frequency to promote the development of pouchitis, even the severe diffuse pouchitis [10,19], which could be explained that greater pouches were prone to have better function of ileal reservoir for feces to decrease defecation frequency and further prevent pouchitis. Consistent with our results, Miratashi Yazdi et al. [14] also demonstrated that a short J pouch led to worse bowel function. However, what pouch volume is appropriate for construct to maintain satisfactory pouch function and decrease the risk of pouchitis remains unknown. Based on previous results, the predominant finding of this study was that a greater J pouch (≥120 mL) significantly improved bowel function, decreased the defecation frequency as well as prevented the development of late complications, especially pouchitis.
Our study had several limitations. First, the loss of follow-up and incomplete clinical data were almost inevitable due to the nature of the retrospective study. Second, although we provided supporting evidence for pouch configuration with appropriate volume, prospective studies with a larger sample size should be performed to further confirm our results. Third, using CGQL and Wexner scores to assess patients with an ileal pouch is suboptimal. Recently, Cavallaro and Bordeianou [29] reported a patient-centered, clinically useful scoring system that can quantify the range and severity of symptoms experienced by ileoanal pouch patients and their correlation with QOL. However, as this study was retrospective, some data pertaining to the above pouch-specific patient-reported outcome measure were missing or were not obtained during follow-up. In future studies, we will improve the completeness of clinical data and use the above measures to better assess the clinical outcomes of patients after IPAA. Fourth, the IPAA procedures were performed by experienced surgeons, the potential influence of inter-surgeon variability on the study outcomes was not evaluated.
In conclusion, this study first indicated that greater pouch volume (≥120 mL) is appropriate for UC patients and found that patients with pouch volume ≥120 mL were more likely to achieve more significantly improved long-term QOL, better bowel function as well as a decreased risk of late postoperative complications, mainly presented as pouchitis. Furthermore, we demonstrated that a small pouch with a volume <120 mL is an independent risk factor for the development of late postoperative complications and impaired long-term QOL. Thus, our study first provided supporting evidence for pouch configuration with appropriate volume in UC patients to make patients achieve better long-term prognosis.

Funding Source

This work was supported by the National Natural Science Foundation of China (Nos. 82570638, 82470549, 82270549), Natural Science Foundation of Shanghai (Nos. 25ZR1402360, 22ZR1440500), the Clinical Research Special Project of Shanghai Municipal Health Commission (20254Y0118), the Interdisciplinary Program of Shanghai Jiaotong University (No. YG2025QNB40), and the Qingfeng Scientific Research Fund of the China Crohn’s & Colitis Foundation (CCCF) (No. CCCF-QF-2022C14-21).

Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Data Availability Statement

Data analyzed in this study are available from the corresponding author upon reasonable request.

Author Contributions

Conceptualization: Du P. Data curation: Xu W, Dai Z. Formal analysis: Xu W, Ding W. Funding acquisition: Xu W, Du P. Investigation: Xu W, Dai Z, Ding W, Cui L, Wu X, Zhou W, Ding Z. Methodology: all authors. Project administration: Xu W, Cui L, Wu X, Zhou W, Ding Z, Du P. Supervision: Du P. Validation: Xu W, Dai Z, Ding W, Du P. Visualization: Xu W, Dai Z. Writingoriginal draft: all authors. Approval of final manuscript: all authors.

Supplementary materials are available at the Intestinal Research website (https://www.irjournal.org).

Supplementary Fig. 1.

Receiver-operating characteristic (ROC) curves of pouch volume in predicting late complications after IPAA. Pouch volume had the most significant area under the ROC curve (AUC) of 0.654 with a sensitivity of 56.9% and specificity of 73.9% at the cutoff value of 120 mL.
ir-2026-00003-Supplementary-Fig-1.pdf
Fig. 1.
The flowchart of this study. UC, ulcerative colitis; IPAA, ileal pouch-anal anastomosis; QOL, quality of life.
ir-2026-00003f1.jpg
Fig. 2.
Analysis of overall late postoperative complications-free survival in patients with pouch volume ≥120 mL or <120 mL by Kaplan-Meier method with the log-rank test.
ir-2026-00003f2.jpg
Fig. 3.
A greater pouch with a volume ≥120 mL promoted better long-term QOL. The pre- and post-IPAA CGQL scores in patients with pouch volume <120 mL (A) and ≥120 mL (B). The postoperative current QOL (C), the current quality of health (D), current energy level (E), and CGQL scores (F) in patients with pouch volume <120 mL and ≥120 mL. QOL, quality of life; IPAA, ileal pouch-anal anastomosis; CGOL, Cleveland Global Quality of Life.
ir-2026-00003f3.jpg
ir-2026-00003f4.jpg
Table 1.
Main Baseline Characteristics of Patients
Variable All cases (n=222)
Sex (male:female) 117:105
Age at diagnosis (yr), median (IQR) 41.0 (29.0–52.0)
Disease duration (yr), median (IQR) 4.0 (2.0–7.0)
Follow-up time (yr), median (IQR) 8.0 (4.0–10.3)
Body mass index (kg/m2), mean±SD 20.1±6.7
Indications for IPAAa
 Medical treatment failure 193 (86.9)
 High drug-related expenses 3 (1.4)
 Serious side effects of medication 4 (1.8)
 Complications needed surgical treatment 12 (5.4)
 Malignant transformation 12 (5.4)
Pouch volume
 <120 mL 117 (52.7)
 ≥120 mL 105 (47.3)
Stage of surgery
 II-stage IPAA 140 (63.1)
 III-stage IPAA 82 (36.9)
Surgical approach
 Open 61 (27.5)
 Laparoscopic 161 (72.5)
Surgical urgency
 Urgent surgery 20 (9.0)
 Elective surgery 202 (91.0)
Extraintestinal manifestations 26 (11.7)
History of surgery 32 (14.4)
Extent of UC
 E1 37 (16.7)
 E2 18 (8.1)
 E3 167 (75.2)
Preoperative medications
 Mesalamine 159 (71.6)
 Biologics 34 (15.3)
 Steroids 137 (61.7)
 Immunomodulators 63 (28.4)
Laboratory data
 Hemoglobin (g/L), mean±SD 110.7±75.3
 Albumin (g/L), mean±SD 34.3±6.9
 WBC counts (×109/L), mean±SD 7.6±3.9
Anesthetic data
 Blood loss (mL), mean±SD 160±169
 Urine volume (mL), mean±SD 573±413
 Infusion volume (mL), mean±SD 1,908±653
 Colloidal amount (mL), mean±SD 659±371
 Operative duration (hr), mean±SD 4.5±1.2
 Length of hospital stay (day), mean±SD 17.3±9.9

Values are presented as number (%) unless otherwise indicated.

a Patients could have more than one indication for IPAA.

IQR, interquartile range; SD, standard deviation; IPAA, ileal pouch-anal anastomosis; UC, ulcerative colitis; WBC, white blood cell.

Table 2.
Main Postoperative Complications of Ileal Pouch-Anal Anastomosis
Complication No. (%)
Early postoperative complicationsa 59 (26.6)
 Early postoperative Intestinal obstruction 30 (13.5)
 Pouch and anastomotic bleeding 11 (5.0)
 Pouch-anal anastomotic leak 9 (4.1)
 Wound infection 16 (7.2)
 Incisional hernia 3 (1.4)
Late postoperative complicationsa 76 (34.2)
 Pouchitis 61 (27.5)
 Pouch failure 3 (1.4)
 Postoperative long-term intestinal obstruction 11 (5.0)
 Pouch-vagina leak 4 (1.8)
 Anastomotic stricture 7 (3.2)
 Sexual dysfunction 1 (0.5)

a Patients could have more than one complication.

Table 3.
Analysis of the Clinical Outcome and Long-Term QOL in Patients with Pouches of Different Volumes
Variable J-pouch volume
 P-value
<120 mL (n=117) ≥120 mL (n=105)
Postoperative CGQL scores, mean±SD 0.731±0.122 0.773±0.138 0.015b
 Current quality of life 7.145±1.620 7.657±1.562 0.018b
 Current quality of health 7.188±1.426 7.600±1.585 0.043b
 Current energy level 7.556±1.600 7.924±1.621 0.093b
Significantly improved long-term QOL, No. (%) 0.013c
 No 56 (47.9) 33 (31.4)
 Yes 61 (52.1) 72 (68.6)
Early postoperative complications, No. (%)a 33 (28.2) 26 (24.8) 0.562c
 Early postoperative intestinal obstruction 0.302c
  No 98 (83.8) 93 (88.6)
  Yes 19 (16.2) 12 (11.4)
 Pouch and anastomotic bleeding 1.000c
  No 111 (94.9) 100 (95.2)
  Yes 6 (5.1) 5 (4.8)
 Wound infection 0.457c
  No 110 (94.0) 96 (91.4)
  Yes 7 (6.0) 9 (8.6)
 Pouch-anal anastomotic leak 0.710d
  No 114 (97.4) 101 (96.2)
  Yes 3 (2.6) 4 (3.8)
 Incisional hernia 1.000d
  No 115 (98.3) 104 (99.0)
  Yes 2 (1.7) 1 (1.0)
Late complications, No. (%)a 50 (42.7) 26 (24.8) 0.005c
 Pouchitis 0.039c
  No 78 (66.7) 83 (79.0)
  Yes 39 (33.3) 22 (21.0)
 Pouch failure 0.604d
  No 116 (99.1) 103 (98.1)
  Yes 1 (0.9) 2 (1.9)
 Postoperative long-term intestinal obstruction 0.610c
  No 112 (95.7) 98 (94.2)
  Yes 5 (4.3) 6 (5.8)
 Pouch-vagina leak 0.624d
  No 114 (97.4) 104 (99.0)
  Yes 3 (2.6) 1 (1.0)
 Anastomotic stricture 0.123d
  No 111 (94.9) 104 (99.0)
  Yes 6 (5.1) 1 (1.0)
 Increased defecation frequency 0.001c
  No 99 (84.6) 102 (97.1)
  Yes 18 (15.4) 3 (2.9)
Wexner scores, mean±SD 7.239±3.999 6.086±3.838 0.030b

a Patients could have more than one early or late complication.

b Two-sample Student t-test.

c Chi-square test.

d Fisher exact test.

QOL, quality of life; CGQL, Cleveland Global Quality of Life; SD, standard deviation; Wexner, Wexner continence score.

Table 4.
Analysis of Risk Factors for Late Postoperative Complications in UC Patients after IPAA
Variable Non-late postoperative complications group (n=146) Late postoperative complications group (n=76) P-value
Age at diagnosis 0.521a
 <40 yr 70 (47.9) 33 (43.4)
 ≥40 yr 76 (52.1) 43 (56.6)
Body mass index 0.535a
 ≥18.5 kg/m2 102 (69.9) 50 (65.8)
 <18.5 kg/m2 44 (30.1) 26 (34.2)
Disease duration 0.491a
 <5 yr 82 (56.2) 39 (51.3)
 ≥5 yr 64 (43.8) 37 (48.7)
Extent of UC 0.212b
 E1 27 (18.5) 10 (13.2)
 E2 13 (8.9) 5 (6.6)
 E3 106 (72.6) 61 (80.3)
Extraintestinal manifestations 0.965a
 No 129 (88.4) 67 (88.2)
 Yes 17 (11.6) 9 (11.8)
Mesalamine 0.152a
 No 46 (31.5) 17 (22.4)
 Yes 100 (68.5) 59 (77.6)
Immunomodulators 0.152a
 No 100 (68.5) 59 (77.6)
 Yes 46 (31.5) 17 (22.4)
Steroids 0.749a
 No 57 (39.0) 28 (36.8)
 Yes 89 (61.0) 48 (63.2)
Biologics 0.520a
 No 122 (83.6) 66 (86.8)
 Yes 24 (16.4) 10 (13.2)
Stage of surgery 0.369b
 II-stage IPAA 89 (61.0) 51 (67.1)
 III-stage IPAA 57 (39.0) 25 (32.9)
Surgical urgency 0.676b
 Urgent surgery 14 (9.6) 6 (7.9)
 Elective surgery 132 (90.4) 70 (92.1)
Surgical approach 0.723a
 Open 39 (26.7) 22 (28.9)
 Laparoscopic 107 (73.3) 54 (71.1)
J-pouch volume 0.005a
 <120 mL 67 (45.9) 50 (65.8)
 ≥120 mL 79 (54.1) 26 (34.2)
Hemoglobin 0.301a
 ≥110 g/L 53 (36.3) 33 (43.4)
 <110 g/L 93 (63.7) 43 (56.6)
Albumin 0.216a
 ≥35 g/L 66 (45.2) 41 (53.9)
 <35 g/L 80 (54.8) 35 (46.1)
WBC counts 0.023a
 <10×109/L 118 (80.8) 51 (67.1)
 ≥10×109/L 28 (19.2) 25 (32.9)
Length of hospital stay 0.004a
 <15 day 82 (56.2) 27 (35.5)
 ≥15 day 64 (43.8) 49 (64.5)
Blood loss 0.016a
 <200 mL 106 (72.6) 43 (56.6)
 ≥200 mL 40 (27.4) 33 (43.4)
Crystalloid-colloid infusion ratio 0.920a
 ≥2 118 (80.8) 61 (80.3)
 <2 28 (19.2) 15 (19.7)
Operative duration 0.035a
 <5 hr 105 (71.9) 44 (57.9)
 ≥5 hr 41 (28.1) 32 (42.1)

Values are presented as number (%).

a Chi-square test.

b Wilcoxon rank-sum test.

UC, ulcerative colitis; IPAA, ileal pouch-anal anastomosis; WBC, white blood cell.

Table 5.
Logistic Regression Analysis of Risk Factors for Late Postoperative Complications in UC Patients after IPAA
Variable Univariate
 Multivariate
OR (95% CI) P-value OR (95% CI) P-value
J-pouch volume <120 mL 2.268 (1.276–4.029) 0.005 2.157 (1.175–3.960) 0.013
WBC counts ≥10×109/L 2.066 (1.099–3.884) 0.024 2.205 (1.122–4.335) 0.022
Blood loss ≥200 mL 2.034 (1.137–3.637) 0.017 1.777 (0.921–3.429) 0.087
Operative duration ≥5 hr 1.863 (1.042–3.330) 0.036 1.927 (1.040–3.569) 0.037
Length of hospital stay ≥15 day 2.325 (1.312–4.121) 0.004 1.645 (0.865–3.129) 0.129

UC, ulcerative colitis; IPAA, ileal pouch-anal anastomosis; OR, odds ratio; CI, confidence interval; WBC, white blood cell.

Table 6.
Analysis of Influencing Factors for Long-Term QOL Improvement in UC Patients after IPAA
Variable Impaired long-term QOL group (n=89) Significantly improved long-term QOL group (n=133) P-value
Age at diagnosis 0.045a
 <40 yr 34 (38.2) 69 (51.9)
 ≥40 yr 55 (61.8) 64 (48.1)
Body mass index 0.231a
 ≥18.5 kg/m2 65 (73.0) 87 (65.4)
 <18.5 kg/m2 24 (27.0) 46 (34.6)
Disease duration 0.682a
 <5 yr 50 (56.2) 71 (53.4)
 ≥5 yr 39 (43.8) 62 (46.6)
Extent of UC 0.735b
 E1 14 (15.7) 23 (17.3)
 E2 7 (7.9) 11 (8.3)
 E3 68 (76.4) 99 (74.4)
Extraintestinal manifestations 0.806a
 No 78 (87.6) 118 (88.7)
 Yes 11 (12.4) 15 (11.3)
Mesalamine 0.405a
 No 28 (31.5) 35 (26.3)
 Yes 61 (68.5) 98 (73.7)
Immunomodulators 0.196a
 No 68 (76.4) 91 (68.4)
 Yes 21 (23.6) 42 (31.6)
Steroids 0.410a
 No 37 (41.6) 48 (36.1)
 Yes 52 (58.4) 85 (63.9)
Biologics 0.368a
 No 73 (82.0) 115 (86.5)
 Yes 16 (18.0) 18 (13.5)
Stage of surgery 0.596b
 II-stage IPAA 58 (65.2) 82 (61.7)
 III-stage IPAA 31 (34.8) 51 (38.3)
Surgical urgency 0.993b
 Urgent surgery 8 (9.0) 12 (9.0)
 Elective surgery 81 (91.0) 121 (91.0)
Surgical approach 0.001a
 Open 35 (39.3) 26 (19.5)
 Laparoscopic 54 (60.7) 107 (80.5)
J-pouch volume 0.013a
 <120 mL 56 (62.9) 61 (45.9)
 ≥120 mL 33 (37.1) 72 (54.1)
Hemoglobin 0.883a
 ≥110 g/L 35 (39.3) 51 (38.3)
 <110 g/L 54 (60.7) 82 (61.7)
Albumin 0.030a
 ≥35 g/L 35 (39.3) 72 (54.1)
 <35 g/L 54 (60.7) 61 (45.9)
White blood cell 0.297a
 <10×109/L 71 (79.8) 98 (73.7)
 ≥10×109/L 18 (20.2) 35 (26.3)
Length of hospital stay 0.017a
 <15 day 35 (39.3) 74 (55.6)
 ≥15 day 54 (60.7) 59 (44.4)

Values are presented as number (%).

a Chi-square test.

b Wilcoxon rank-sum test.

QOL, quality of life; UC, ulcerative colitis; IPAA, ileal pouch-anal anastomosis.

Table 7.
Logistic Regression Analysis of Risk Factors for Impaired Long-Term QOL in UC Patients after IPAA
Variables Univariate
 Multivariate
OR (95% CI) P-value OR (95% CI) P-value
Age at diagnosis ≥40 yr 1.744 (1.010–3.012) 0.046 1.977 (1.100–3.555) 0.023
Open surgery 2.667 (1.458–4.879) 0.001 2.590 (1.284–5.222) 0.008
J-pouch volume <120 mL 2.003 (1.157–3.468) 0.013 2.049 (1.130–3.715) 0.018
Albumin <35 g/L 1.821 (1.056–3.141) 0.031 2.310 (1.270–4.203) 0.006
Length of hospital stay ≥15 day 1.935 (1.121–3.340) 0.018 1.355 (0.724–2.534) 0.342

QOL, quality of life; UC, ulcerative colitis; IPAA, ileal pouch-anal anastomosis; OR, odds ratio; CI, confidence interval.

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      Appropriate J-pouch volume associated with improved clinical outcomes and long-term quality of life in patients with ulcerative colitis after ileal pouch-anal anastomosis: results from China UC Pouch Center Union
      Image Image Image Image
      Fig. 1. The flowchart of this study. UC, ulcerative colitis; IPAA, ileal pouch-anal anastomosis; QOL, quality of life.
      Fig. 2. Analysis of overall late postoperative complications-free survival in patients with pouch volume ≥120 mL or <120 mL by Kaplan-Meier method with the log-rank test.
      Fig. 3. A greater pouch with a volume ≥120 mL promoted better long-term QOL. The pre- and post-IPAA CGQL scores in patients with pouch volume <120 mL (A) and ≥120 mL (B). The postoperative current QOL (C), the current quality of health (D), current energy level (E), and CGQL scores (F) in patients with pouch volume <120 mL and ≥120 mL. QOL, quality of life; IPAA, ileal pouch-anal anastomosis; CGOL, Cleveland Global Quality of Life.
      Graphical abstract

      Fig. 1.

      Fig. 2.

      Fig. 3.

      Graphical abstract

      Appropriate J-pouch volume associated with improved clinical outcomes and long-term quality of life in patients with ulcerative colitis after ileal pouch-anal anastomosis: results from China UC Pouch Center Union
      Variable All cases (n=222)
      Sex (male:female) 117:105
      Age at diagnosis (yr), median (IQR) 41.0 (29.0–52.0)
      Disease duration (yr), median (IQR) 4.0 (2.0–7.0)
      Follow-up time (yr), median (IQR) 8.0 (4.0–10.3)
      Body mass index (kg/m2), mean±SD 20.1±6.7
      Indications for IPAAa
       Medical treatment failure 193 (86.9)
       High drug-related expenses 3 (1.4)
       Serious side effects of medication 4 (1.8)
       Complications needed surgical treatment 12 (5.4)
       Malignant transformation 12 (5.4)
      Pouch volume
       <120 mL 117 (52.7)
       ≥120 mL 105 (47.3)
      Stage of surgery
       II-stage IPAA 140 (63.1)
       III-stage IPAA 82 (36.9)
      Surgical approach
       Open 61 (27.5)
       Laparoscopic 161 (72.5)
      Surgical urgency
       Urgent surgery 20 (9.0)
       Elective surgery 202 (91.0)
      Extraintestinal manifestations 26 (11.7)
      History of surgery 32 (14.4)
      Extent of UC
       E1 37 (16.7)
       E2 18 (8.1)
       E3 167 (75.2)
      Preoperative medications
       Mesalamine 159 (71.6)
       Biologics 34 (15.3)
       Steroids 137 (61.7)
       Immunomodulators 63 (28.4)
      Laboratory data
       Hemoglobin (g/L), mean±SD 110.7±75.3
       Albumin (g/L), mean±SD 34.3±6.9
       WBC counts (×109/L), mean±SD 7.6±3.9
      Anesthetic data
       Blood loss (mL), mean±SD 160±169
       Urine volume (mL), mean±SD 573±413
       Infusion volume (mL), mean±SD 1,908±653
       Colloidal amount (mL), mean±SD 659±371
       Operative duration (hr), mean±SD 4.5±1.2
       Length of hospital stay (day), mean±SD 17.3±9.9
      Complication No. (%)
      Early postoperative complicationsa 59 (26.6)
       Early postoperative Intestinal obstruction 30 (13.5)
       Pouch and anastomotic bleeding 11 (5.0)
       Pouch-anal anastomotic leak 9 (4.1)
       Wound infection 16 (7.2)
       Incisional hernia 3 (1.4)
      Late postoperative complicationsa 76 (34.2)
       Pouchitis 61 (27.5)
       Pouch failure 3 (1.4)
       Postoperative long-term intestinal obstruction 11 (5.0)
       Pouch-vagina leak 4 (1.8)
       Anastomotic stricture 7 (3.2)
       Sexual dysfunction 1 (0.5)
      Variable J-pouch volume
      		 P-value
      <120 mL (n=117) ≥120 mL (n=105)
      Postoperative CGQL scores, mean±SD 0.731±0.122 0.773±0.138 0.015b
       Current quality of life 7.145±1.620 7.657±1.562 0.018b
       Current quality of health 7.188±1.426 7.600±1.585 0.043b
       Current energy level 7.556±1.600 7.924±1.621 0.093b
      Significantly improved long-term QOL, No. (%) 0.013c
       No 56 (47.9) 33 (31.4)
       Yes 61 (52.1) 72 (68.6)
      Early postoperative complications, No. (%)a 33 (28.2) 26 (24.8) 0.562c
       Early postoperative intestinal obstruction 0.302c
        No 98 (83.8) 93 (88.6)
        Yes 19 (16.2) 12 (11.4)
       Pouch and anastomotic bleeding 1.000c
        No 111 (94.9) 100 (95.2)
        Yes 6 (5.1) 5 (4.8)
       Wound infection 0.457c
        No 110 (94.0) 96 (91.4)
        Yes 7 (6.0) 9 (8.6)
       Pouch-anal anastomotic leak 0.710d
        No 114 (97.4) 101 (96.2)
        Yes 3 (2.6) 4 (3.8)
       Incisional hernia 1.000d
        No 115 (98.3) 104 (99.0)
        Yes 2 (1.7) 1 (1.0)
      Late complications, No. (%)a 50 (42.7) 26 (24.8) 0.005c
       Pouchitis 0.039c
        No 78 (66.7) 83 (79.0)
        Yes 39 (33.3) 22 (21.0)
       Pouch failure 0.604d
        No 116 (99.1) 103 (98.1)
        Yes 1 (0.9) 2 (1.9)
       Postoperative long-term intestinal obstruction 0.610c
        No 112 (95.7) 98 (94.2)
        Yes 5 (4.3) 6 (5.8)
       Pouch-vagina leak 0.624d
        No 114 (97.4) 104 (99.0)
        Yes 3 (2.6) 1 (1.0)
       Anastomotic stricture 0.123d
        No 111 (94.9) 104 (99.0)
        Yes 6 (5.1) 1 (1.0)
       Increased defecation frequency 0.001c
        No 99 (84.6) 102 (97.1)
        Yes 18 (15.4) 3 (2.9)
      Wexner scores, mean±SD 7.239±3.999 6.086±3.838 0.030b
      Variable Non-late postoperative complications group (n=146) Late postoperative complications group (n=76) P-value
      Age at diagnosis 0.521a
       <40 yr 70 (47.9) 33 (43.4)
       ≥40 yr 76 (52.1) 43 (56.6)
      Body mass index 0.535a
       ≥18.5 kg/m2 102 (69.9) 50 (65.8)
       <18.5 kg/m2 44 (30.1) 26 (34.2)
      Disease duration 0.491a
       <5 yr 82 (56.2) 39 (51.3)
       ≥5 yr 64 (43.8) 37 (48.7)
      Extent of UC 0.212b
       E1 27 (18.5) 10 (13.2)
       E2 13 (8.9) 5 (6.6)
       E3 106 (72.6) 61 (80.3)
      Extraintestinal manifestations 0.965a
       No 129 (88.4) 67 (88.2)
       Yes 17 (11.6) 9 (11.8)
      Mesalamine 0.152a
       No 46 (31.5) 17 (22.4)
       Yes 100 (68.5) 59 (77.6)
      Immunomodulators 0.152a
       No 100 (68.5) 59 (77.6)
       Yes 46 (31.5) 17 (22.4)
      Steroids 0.749a
       No 57 (39.0) 28 (36.8)
       Yes 89 (61.0) 48 (63.2)
      Biologics 0.520a
       No 122 (83.6) 66 (86.8)
       Yes 24 (16.4) 10 (13.2)
      Stage of surgery 0.369b
       II-stage IPAA 89 (61.0) 51 (67.1)
       III-stage IPAA 57 (39.0) 25 (32.9)
      Surgical urgency 0.676b
       Urgent surgery 14 (9.6) 6 (7.9)
       Elective surgery 132 (90.4) 70 (92.1)
      Surgical approach 0.723a
       Open 39 (26.7) 22 (28.9)
       Laparoscopic 107 (73.3) 54 (71.1)
      J-pouch volume 0.005a
       <120 mL 67 (45.9) 50 (65.8)
       ≥120 mL 79 (54.1) 26 (34.2)
      Hemoglobin 0.301a
       ≥110 g/L 53 (36.3) 33 (43.4)
       <110 g/L 93 (63.7) 43 (56.6)
      Albumin 0.216a
       ≥35 g/L 66 (45.2) 41 (53.9)
       <35 g/L 80 (54.8) 35 (46.1)
      WBC counts 0.023a
       <10×109/L 118 (80.8) 51 (67.1)
       ≥10×109/L 28 (19.2) 25 (32.9)
      Length of hospital stay 0.004a
       <15 day 82 (56.2) 27 (35.5)
       ≥15 day 64 (43.8) 49 (64.5)
      Blood loss 0.016a
       <200 mL 106 (72.6) 43 (56.6)
       ≥200 mL 40 (27.4) 33 (43.4)
      Crystalloid-colloid infusion ratio 0.920a
       ≥2 118 (80.8) 61 (80.3)
       <2 28 (19.2) 15 (19.7)
      Operative duration 0.035a
       <5 hr 105 (71.9) 44 (57.9)
       ≥5 hr 41 (28.1) 32 (42.1)
      Variable Univariate
      		 Multivariate
      OR (95% CI) P-value OR (95% CI) P-value
      J-pouch volume <120 mL 2.268 (1.276–4.029) 0.005 2.157 (1.175–3.960) 0.013
      WBC counts ≥10×109/L 2.066 (1.099–3.884) 0.024 2.205 (1.122–4.335) 0.022
      Blood loss ≥200 mL 2.034 (1.137–3.637) 0.017 1.777 (0.921–3.429) 0.087
      Operative duration ≥5 hr 1.863 (1.042–3.330) 0.036 1.927 (1.040–3.569) 0.037
      Length of hospital stay ≥15 day 2.325 (1.312–4.121) 0.004 1.645 (0.865–3.129) 0.129
      Variable Impaired long-term QOL group (n=89) Significantly improved long-term QOL group (n=133) P-value
      Age at diagnosis 0.045a
       <40 yr 34 (38.2) 69 (51.9)
       ≥40 yr 55 (61.8) 64 (48.1)
      Body mass index 0.231a
       ≥18.5 kg/m2 65 (73.0) 87 (65.4)
       <18.5 kg/m2 24 (27.0) 46 (34.6)
      Disease duration 0.682a
       <5 yr 50 (56.2) 71 (53.4)
       ≥5 yr 39 (43.8) 62 (46.6)
      Extent of UC 0.735b
       E1 14 (15.7) 23 (17.3)
       E2 7 (7.9) 11 (8.3)
       E3 68 (76.4) 99 (74.4)
      Extraintestinal manifestations 0.806a
       No 78 (87.6) 118 (88.7)
       Yes 11 (12.4) 15 (11.3)
      Mesalamine 0.405a
       No 28 (31.5) 35 (26.3)
       Yes 61 (68.5) 98 (73.7)
      Immunomodulators 0.196a
       No 68 (76.4) 91 (68.4)
       Yes 21 (23.6) 42 (31.6)
      Steroids 0.410a
       No 37 (41.6) 48 (36.1)
       Yes 52 (58.4) 85 (63.9)
      Biologics 0.368a
       No 73 (82.0) 115 (86.5)
       Yes 16 (18.0) 18 (13.5)
      Stage of surgery 0.596b
       II-stage IPAA 58 (65.2) 82 (61.7)
       III-stage IPAA 31 (34.8) 51 (38.3)
      Surgical urgency 0.993b
       Urgent surgery 8 (9.0) 12 (9.0)
       Elective surgery 81 (91.0) 121 (91.0)
      Surgical approach 0.001a
       Open 35 (39.3) 26 (19.5)
       Laparoscopic 54 (60.7) 107 (80.5)
      J-pouch volume 0.013a
       <120 mL 56 (62.9) 61 (45.9)
       ≥120 mL 33 (37.1) 72 (54.1)
      Hemoglobin 0.883a
       ≥110 g/L 35 (39.3) 51 (38.3)
       <110 g/L 54 (60.7) 82 (61.7)
      Albumin 0.030a
       ≥35 g/L 35 (39.3) 72 (54.1)
       <35 g/L 54 (60.7) 61 (45.9)
      White blood cell 0.297a
       <10×109/L 71 (79.8) 98 (73.7)
       ≥10×109/L 18 (20.2) 35 (26.3)
      Length of hospital stay 0.017a
       <15 day 35 (39.3) 74 (55.6)
       ≥15 day 54 (60.7) 59 (44.4)
      Variables Univariate
      		 Multivariate
      OR (95% CI) P-value OR (95% CI) P-value
      Age at diagnosis ≥40 yr 1.744 (1.010–3.012) 0.046 1.977 (1.100–3.555) 0.023
      Open surgery 2.667 (1.458–4.879) 0.001 2.590 (1.284–5.222) 0.008
      J-pouch volume <120 mL 2.003 (1.157–3.468) 0.013 2.049 (1.130–3.715) 0.018
      Albumin <35 g/L 1.821 (1.056–3.141) 0.031 2.310 (1.270–4.203) 0.006
      Length of hospital stay ≥15 day 1.935 (1.121–3.340) 0.018 1.355 (0.724–2.534) 0.342
      Table 1. Main Baseline Characteristics of Patients

      Values are presented as number (%) unless otherwise indicated.

      Patients could have more than one indication for IPAA.

      IQR, interquartile range; SD, standard deviation; IPAA, ileal pouch-anal anastomosis; UC, ulcerative colitis; WBC, white blood cell.

      Table 2. Main Postoperative Complications of Ileal Pouch-Anal Anastomosis

      Patients could have more than one complication.

      Table 3. Analysis of the Clinical Outcome and Long-Term QOL in Patients with Pouches of Different Volumes

      Patients could have more than one early or late complication.

      Two-sample Student t-test.

      Chi-square test.

      Fisher exact test.

      QOL, quality of life; CGQL, Cleveland Global Quality of Life; SD, standard deviation; Wexner, Wexner continence score.

      Table 4. Analysis of Risk Factors for Late Postoperative Complications in UC Patients after IPAA

      Values are presented as number (%).

      Chi-square test.

      Wilcoxon rank-sum test.

      UC, ulcerative colitis; IPAA, ileal pouch-anal anastomosis; WBC, white blood cell.

      Table 5. Logistic Regression Analysis of Risk Factors for Late Postoperative Complications in UC Patients after IPAA

      UC, ulcerative colitis; IPAA, ileal pouch-anal anastomosis; OR, odds ratio; CI, confidence interval; WBC, white blood cell.

      Table 6. Analysis of Influencing Factors for Long-Term QOL Improvement in UC Patients after IPAA

      Values are presented as number (%).

      Chi-square test.

      Wilcoxon rank-sum test.

      QOL, quality of life; UC, ulcerative colitis; IPAA, ileal pouch-anal anastomosis.

      Table 7. Logistic Regression Analysis of Risk Factors for Impaired Long-Term QOL in UC Patients after IPAA

      QOL, quality of life; UC, ulcerative colitis; IPAA, ileal pouch-anal anastomosis; OR, odds ratio; CI, confidence interval.

      Table 1.

      Table 2.

      Table 3.

      Table 4.

      Table 5.

      Table 6.

      Table 7.

      Intest Res : Intestinal Research
      © Korean Association for the Study of Intestinal Diseases.
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