Impact of BMI on Ability to Successfully Create an IPAA

BACKGROUND: IPAA is the surgical treatment of choice for patients with ulcerative colitis. Limited data exist on how obesity impacts the ability of the surgeon to successfully create an IPAA. OBJECTIVE: We aimed to determine how BMI affects the ability to successfully complete the operation. DESIGN: This was a retrospective cohort study. SETTINGS: The study was conducted at a single tertiary care center. PATIENTS: We included all of the patients undergoing an IPAA for ulcerative colitis between January 2002 and August 2013 at our institution. A total of 1175 patients underwent proctocolectomy for ulcerative colitis during the study period; 129 were not offered IPAA (reasons included patient preference (n = 53), advanced age/comorbidity (n = 28), obesity (n = 23), incontinence (n = 8), suspicion of Crohn’s disease (n = 8), rectal cancer (n = 3), and other (n = 6)). Twenty-six patients had a concurrent cancer diagnosis, and 5 had a polyposis syndrome. MAIN OUTCOME MEASURES: We used logistic regression modeling to estimate the association between BMI and unsuccessful pouch attempts. RESULTS: Of the 1046 patients offered IPAA, 19 (1.82%) could not be technically completed at the time of surgery. Increasing BMI was associated with a higher risk of not being able to technically perform IPAA (OR = 1.26 (95% CI, 1.17–1.34)). The chance of an unsuccessful pouch rose from 2.0% at a BMI of 30 to 5.7% at a BMI of 35 and 15.0% at a BMI of 40 (p
Source: Diseases of the Colon and Rectum - Category: Gastroenterology Tags: Original Contributions: Inflammatory Bowel Disease Source Type: research