The effect of percentage of ideal body weight on outcomes in ileo-anal pull through for ulcerative colitis.

ABSTRACT

PURPOSE: Ileo-anal pull through (IAPT) is a commonly performed operation for the surgical management of ulcerative colitis. The effect of body weight on outcomes for patients undergoing this operation has not been extensively studied. METHODS: This was a prospective cohort study at a single tertiary care inflammatory bowel disease (IBD) center. A total of 457 patients who were operated on at the Mount Sinai Medical Center between 1983 and 2015 were included. Demographic characteristics, the patients' body weight at the time of IAPT, and postoperative outcome data were collected. RESULTS: For each patient, body weight was calculated as a percentage of the ideal body weight (IBW) for that patient's height. The mean percentage of ideal body weight was 93.9% with a standard deviation of 20%. The range for the population was 53.1 to 175%. Four hundred forty (96%) of the patients had a weight within two standard deviations of the mean, indicating a normal distribution. Seventy-nine patients developed a Clavien-Dindo class III complication necessitating a procedural treatment. The most common of these was a stricture at the anastomotic site (n = 54). Our study identified an association between a percentage of ideal body weight in the lowest quartile of our population and development of an anastomotic stricture. This association was statistically significant on multivariate analysis. CONCLUSION: Low body weight at the time of ileo-anal pull through for treatment of UC may be a risk factor for development of anastomotic stricture requiring dilation.