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Pouch surgery for ulcerative colitis in 2025: A narrative review
Andrea Vignali1, Pierpaolo Sileri1
1Department of Colorectal Surgery, San Raffaele Scientific Institute, Vita e salute University Milan, Italy.
Best Practice & Research. Clinical Gastroenterology
|August 6, 2025
Summary
Restorative proctocolectomy with ileoanal pouch surgery is evolving. Minimally invasive and trans-anal approaches offer promise but require careful patient selection and experienced surgeons for optimal outcomes.
Area of Science:
- Gastroenterology and Surgical Oncology
Background:
- Restorative proctocolectomy with ileoanal pouch is standard for refractory ulcerative colitis and selected Crohn's disease.
- Biologics have impacted colectomy rates, surgical timing, and approach complexity.
Purpose of the Study:
- To analyze advancements in ileoanal pouch surgery.
- Focus on staging, minimally invasive surgery, and trans-anal approaches.
Main Methods:
- Review of current surgical strategies and outcomes in ileoanal pouch procedures.
- Analysis of factors influencing surgical decisions and approach selection.
Main Results:
- Individualized staging is crucial, considering disease severity, nutrition, and pre-op treatments.
- Minimally invasive approaches are recommended when feasible.
- Trans-anal ileal pouch surgery is promising but technically demanding, requiring expert surgeons.
Conclusions:
- Minimally invasive techniques in pouch surgery are advancing.
- Further large-scale controlled studies are necessary to validate efficacy and safety.
Keywords:
Ileoanal pouchLaparoscopic IPAARestorative proctocolectomyTrans-Anal IPAAUlcerative colitisMore Related Videos
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