BACKGROUND Ileal pouch-anal anastomosis has become the standard surgical procedure for patients with ulcerative colitis who require colectomy. Presacral sinus is a common complication after the surgery. Pouch sinus results from chronic anastomotic or suture line leak. An excessive gain in body mass index (BMI) has been shown to be associated with poor pouch outcome. The aim of this study was to evaluate whether an increase in BMI was associated with recurrences of chronic pouch sinus after endoscopic or surgical treatment. METHODS All consecutive ulcerative colitis patients with an ileal pouch sinus successfully treated with either endoscopic sinusotomy or redo surgery from 2006 to 2016 were identified from our IRB approved, prospectively maintained Pouch Registry. An excessive gain in BMI was defined as an increase in BMI ≥ 10% from the baseline of the initial endoscopic or surgical treatment. The primary outcome was sinus recurrence after initial complete healing. RESULTS This study included a total of 171 patients. Sinus recurrence was seen in 48 (28.1%) patients. A higher rate of recurrence of sinus was found in patients with BMI gain (≥ 10%) (22.9% vs. 8.9%, p = 0.01). However, the recurrence-free survival in Kaplan-Meier analysis between the BMI gain and non-BMI gain groups was not statistically significant (p = 0.10). In multivariate analysis, excessive BMI gain [odds ratio (OR) 3.0, 95% confidence interval (CI) 1.0-9.0)] and Crohn's disease of the pouch (OR 2.9, 95% CI 1.0-8.1) were independently associated with sinus recurrence. The healing rate of recurrent sinus after subsequent endoscopic or surgical treatment was comparable between those who had an excessive increase in BMI and those who maintained a relatively stable weight (63.6% vs. 70.3%, p = 0.81). However, the recurrent presacral sinus-related pouch failure rate was numerically higher in patients with an excessive BMI gain (36.4% vs. 16.2%, p = 0.31). CONCLUSIONS An excessive gain in BMI after initial successful pouch sinus treatment is associated with an increased risk for sinus recurrence. Weight control may help decrease the risk for recurrence of pouch sinus.

中文翻译：

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内镜或手术治疗后，体重指数的程序性增加与回肠袋窦的复发有关。

背景技术回肠囊袋肛门吻合术已成为需要结肠切除术的溃疡性结肠炎患者的标准手术方法。s前窦是手术后的常见并发症。袋窦是慢性吻合或缝合线漏出引起的。体重指数（BMI）的过度增加已被证明与小袋结局不良有关。这项研究的目的是评估内镜或手术治疗后BMI的增加是否与慢性袋窦的复发有关。方法从我们的IRB批准且前瞻性维护的Pouch Registry中，鉴定出2006年至2016年间所有成功通过内窥镜鼻窦切开术或重做手术治疗的回肠囊窦的溃疡性结肠炎患者。BMI的过度增加被定义为与初始内镜或手术治疗基线相比BMI≥10％的增加。主要结局是最初完全治愈后的鼻窦复发。结果本研究共纳入171例患者。鼻窦复发出现在48位（28.1％）患者中。BMI增高（≥10％）的患者发现鼻窦复发率更高（22.9％比8.9％，p = 0.01）。但是，在Kaplan-Meier分析中，BMI增高组和非BMI增高组之间的无复发生存率无统计学意义（p = 0.10）。在多变量分析中，过度的BMI增高[优势比（OR）3.0，95％置信区间（CI）1.0-9.0）]和袋囊克罗恩氏病（OR 2.9，95％CI 1.0-8.1）与鼻窦复发独立相关。BMI过度增加的患者和体重保持相对稳定的患者在随后的内窥镜或手术治疗后的复发性鼻窦愈合率相当（63.6％对70.3％，p = 0.81）。但是，BMI过度增加的患者复发性pre前窦相关囊失败率在数值上更高（36.4％vs. 16.2％，p = 0.31）。结论最初成功进行袋窦治疗后，BMI过多增加与鼻窦复发风险增加有关。体重控制可以帮助减少袋窦复发的风险。BMI增高的患者复发性pre前窦相关囊袋失败率更高（36.4％vs. 16.2％，p = 0.31）。结论最初成功进行袋窦治疗后，BMI过多增加与鼻窦复发风险增加有关。体重控制可能有助于降低袋窦复发的风险。BMI增高的患者复发性pre前窦相关囊袋失败率更高（36.4％vs. 16.2％，p = 0.31）。结论最初成功进行袋窦治疗后，BMI过多增加与鼻窦复发风险增加有关。体重控制可能有助于降低袋窦复发的风险。