Association of preoperative neoplasia and rectal cuff inflammation on initial pouchoscopy with subsequent neoplasia development in inflammatory bowel disease patients with an ileal pouch-anal anastomosis: a case-control study.

Authors

Joseph Carter Powers, Mark Zemanek, Mili Dave, Emma Dester, Katherine Westbrook Cates, Riley Smith, Tracy Hull, Olga Lavryk, Benjamin L Cohen, Bret Lashner, Andrei I Ivanov, Edward Barnes, Katherine Falloon, Manuel Braga-Neto, Taha Qazi

Published in

Inflammatory bowel diseases. Jun 30, 2026. Epub Jun 30, 2026.

Abstract

Neoplasia of the pouch or rectal cuff is a rare cause of pouch failure in patients with an ileal pouch-anal anastomosis. Cuff inflammation has been suggested to convey a higher neoplasia risk but has not been thoroughly investigated. This study evaluated whether endoscopic inflammation of the rectal cuff conveys increased risk of subsequent neoplasia development.
This was a 2-institution case-control study of inflammatory bowel disease patients who developed neoplasia of the rectal cuff or ileal pouch and patients without neoplasia. Cases were matched to controls in a 1:4 ratio. Neoplasia was defined as dysplasia or adenocarcinoma, and cuff inflammation was defined as endoscopic evidence of erythema, edema, and/or ulcerations. A subanalysis assessed whether persistent inflammation conveys a higher neoplasia risk than resolved cuff inflammation.
Forty-six cases of neoplasia were matched to 184 controls. Rectal cuff dysplasia (n = 23) was most common, followed by pouch dysplasia, cuff cancer, pouch cancer, and neoplasia involving both sites. Patients with cuff inflammation on initial pouchoscopy (adjusted odds ratio [aOR] = 2.82; 95% CI, 1.24-7.74; P = .013) had a higher risk of developing neoplasia. Compared to controls, patients with persistent cuff inflammation had a higher risk of neoplasia development (aOR = 3.70; 95% CI, 1.37-9.97; P = .010), but this trend was not observed in patients with inflammation on only one pouchoscopy.
Patients with inflammation of the rectal cuff on initial pouchoscopy are at higher risk of subsequent neoplasia development, and this risk appears highest in patients with persistent inflammation.

PMID:
42378713
Bibliographic data and abstract were imported from PubMed on 01 Jul 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.