Evaluation of colorectal surgeons’ approaches to ileal pouch–anal anastomosis in ulcerative colitis patients

Abstract Introduction: Restorative proctocolectomy with ileal pouch–anal anastomosis (IPAA) has become the standard of care for elective surgery for patients with ulcerative colitis (UC). However, there are different surgical techniques and several patient variations affecting their outcomes. The aim of this international multicenter study is to assess the approaches of colorectal surgeons toward IPAA procedures. Methods: Thirty colorectal surgeons practicing in Saudi Arabia, UAE, and Oman were asked to complete a questionnaire on their knowledge of indications, complications of IPAA, and practice in selecting stoma versus restorative IPAA for patients with UC. Results: Around 83.3% ( n = 25) of participants were affiliated with academic tertiary hospitals and 66.7% ( n = 20) had an inflammatory bowel disease (IBD) multidisciplinary board at their center. Regarding colorectal surgery fellowship, Author 2: 63.3% ( n = 19) of participants were trained abroad (USA, Canada, Korea, Belgium, France, Germany, and UK) and 36.6% ( n = 11) were trained in Saudi Arabia.. Most surgeons performed IPAA independently in their practice (73.3%, n = 22), with an average of 10–20 IBD surgeries per year (50%, n = 15). All the participants agreed that IPAA is indicated in UC patients, while only 5.9% ( n = 1) of participants said that they would perform IPAA for indeterminate colitis. Most of the cohort (70.6%, n = xx) routinely performed two-stage IPAA, while only 29.4% ( n = xx) of participants would routinely perform three-stage IPAA. Conclusion: This survey demonstrates that IPAA is a popular option to improve the quality of life with patients who are required to have surgical treatment. However, there is a need for a multidisciplinary approach to create sustainable outcomes for every patient’s variation.