Association of narrow pelvis and body composition with anastomotic stricture following total proctocolectomy with ileal pouch–anal anastomosis for ulcerative colitis

What To Know

This paper reports a retrospective cohort study of 55 ulcerative colitis patients who underwent total proctocolectomy with ileal pouch–anal anastomosis (TPC–IPAA).

The authors measured pelvic dimensions and body-composition metrics on preoperative CT and examined associations with severe anastomotic stricture (defined as requiring endoscopic balloon dilatation within 1 year). They found that a smaller composite pelvic size (pelvic index) was associated with higher odds of severe anastomotic stricture after TPC–IPAA.

Higher skeletal muscle index and greater visceral fat were also associated in univariable analyses, but only the pelvic index remained significant in multivariable modeling; the muscle finding was borderline.

These results suggest preoperative pelvic anatomy and body composition might help identify patients at higher risk for pouch anastomotic strictures, which could inform surgical planning or closer postoperative surveillance.