Imperial College London
Portrait Picture

Mr Christos Kontovounisios

Faculty of Medicine, Department of Surgery & Cancer

Visiting Reader
 
 
 
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Contact

 

+44 (0)20 3315 8529c.kontovounisios

 
 
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Location

 

Chelsea and Westminster HospitalChelsea and Westminster Campus

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Summary

 

Publications

Citation

BibTex format

@article{Fadel:2023:ecco-jcc/jjad051,
author = {Fadel, MG and Geropoulos, G and Warren, OJ and Mills, SC and Tekkis, PP and Celentano, V and Kontovounisios, C},
doi = {ecco-jcc/jjad051},
journal = {Journal of Crohn's and Colitis},
pages = {1537--1548},
title = {Risks factors associated with the development of Crohn's disease after ileal pouch-anal anastomosis for ulcerative colitis: a systematic review and meta-analysis},
url = {http://dx.doi.org/10.1093/ecco-jcc/jjad051},
volume = {17},
year = {2023}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundFollowing ileal pouch–anal anastomosis [IPAA] for ulcerative colitis [UC], up to 16% of patients develop Crohn’s disease of the pouch [CDP], which is a major cause of pouch failure. This systematic review and meta-analysis aimed to identify preoperative characteristics and risk factors for CDP development following IPAA.MethodsA literature search of the MEDLINE, EMBASE, EMCare and CINAHL databases was performed for studies that reported data on predictive characteristics and outcomes of CDP development in patients who underwent IPAA for UC between January 1990 and August 2022. Meta-analysis was performed using random-effect models and between-study heterogeneity was assessed.ResultsSeven studies with 1274 patients were included: 767 patients with a normal pouch and 507 patients with CDP. Age at UC diagnosis (weighted mean difference [WMD] −2.85; 95% confidence interval [CI] −4.39 to −1.31; p=0.0003; I2 54%) and age at pouch surgery [WMD −3.17; 95% CI −5.27 to −1.07; p=0.003; I2 20%) were significantly lower in patients who developed CDP compared to a normal pouch. Family history of IBD was significantly associated with CDP (odds ratio [OR] 2.43; 95% CI 1.41–4.19; p=0.001; I2 31%], along with a history of smoking [OR 1.80; 95% CI 1.35–2.39; p<0.0001; I2 0%]. Other factors such as sex and primary sclerosing cholangitis were found not to increase the risk of CDP.ConclusionsAge at UC diagnosis and pouch surgery, family history of IBD and previous smoking have been identified as potential risk factors for CDP post-IPAA. This has important implications towards preoperative counselling, planning surgical management and evaluating prognosis.
AU  - Fadel,MG
AU  - Geropoulos,G
AU  - Warren,OJ
AU  - Mills,SC
AU  - Tekkis,PP
AU  - Celentano,V
AU  - Kontovounisios,C
DO  - ecco-jcc/jjad051
EP  - 1548
PY  - 2023///
SN  - 1873-9946
SP  - 1537
TI  - Risks factors associated with the development of Crohn's disease after ileal pouch-anal anastomosis for ulcerative colitis: a systematic review and meta-analysis
T2  - Journal of Crohn's and Colitis
UR  - http://dx.doi.org/10.1093/ecco-jcc/jjad051
UR  - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000974140500001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=a2bf6146997ec60c407a63945d4e92bb
UR  - https://academic.oup.com/ecco-jcc/article/17/9/1537/7085614
UR  - http://hdl.handle.net/10044/1/110453
VL  - 17
ER  -
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