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Xu W, Liu F, Hua Z, Gu Y, Lian L, Cui L, Ding Z, Du P. Comparison of The Toronto IBD Global Endoscopic Reporting (TIGER) score, Mayo endoscopic score (MES), and ulcerative colitis endoscopic index of severity (UCEIS) in predicting the need for ileal pouch-anal anastomosis in patients with ulcerative colitis. Int J Colorectal Dis 2023; 38:53. [PMID: 36840832 DOI: 10.1007/s00384-023-04347-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/13/2023] [Indexed: 02/26/2023]
Abstract
BACKGROUND Total proctocolectomy (TPC) with ileal pouch-anal anastomosis (IPAA) has been accepted as a radical surgery for refractory ulcerative colitis (UC). We aimed to assess the predictive value of several novel and widely used endoscopic core systems, The Toronto IBD Global Endoscopic Reporting (TIGER) score, Mayo endoscopic score (MES), and ulcerative colitis endoscopic index of severity (UCEIS) in guiding the need for IPAA. METHODS Data on patients with UC from June 1986 and June 2022 at our institute were collected. The endoscopic evaluation was recorded according to the first colonoscopy after hospitalization. Primary outcome was the need for IPAA during admission and follow-up. RESULTS A total of 313 patients with a median follow-up time and a median TIGER score of 12.0 years (interquartile range (IQR): 6.0-17.0) and 212.0 (IQR: 7.0-327.0) were enrolled. IPAA was conducted in 110 (35.1%) patients, which significantly improved the long-term quality of life. TIGER score had the biggest area under the receiver-operating characteristic curve of 0.810 with a sensitivity of 75.0% and specificity of 87.1% at the cut-off value of 315 (p < 0.001). TIGER score ≥ 315 was an independent risk factor with the highest odds ratio for the need for IPAA and associated with the shortest IPAA-free survival time compared with UCEIS and MES. CONCLUSION TIGER score was superior to UCEIS and MES in predicting the need for IPAA. For colorectal surgeons, three or more segments with moderate-to-severe endoscopic activity should be considered as a threshold value for decision-making for IPAA.
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Affiliation(s)
- Weimin Xu
- Department of Colorectal Surgery, School of Medicine, Xinhua Hospital, Shanghai Jiaotong University, Shanghai, 200092, China
| | - Fangyuan Liu
- Department of Colorectal Surgery, School of Medicine, Xinhua Hospital, Shanghai Jiaotong University, Shanghai, 200092, China
| | - Zhebin Hua
- Department of Colorectal Surgery, School of Medicine, Xinhua Hospital, Shanghai Jiaotong University, Shanghai, 200092, China
| | - Yubei Gu
- Department of Gastroenterology, School of Medicine, Rui Jin Hospital, Affiliated to Shanghai Jiao Tong University, 197 Rui Jin Er Road, Shanghai, 200025, China.
| | - Lei Lian
- Department of Gastrointestinal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, 510655, Guangzhou, China
| | - Long Cui
- Department of Colorectal Surgery, School of Medicine, Xinhua Hospital, Shanghai Jiaotong University, Shanghai, 200092, China
| | - Zhao Ding
- Department of Colorectal and Anal Surgery, Hubei Key Laboratory of Intestinal and Colorectal Diseases, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Peng Du
- Department of Colorectal Surgery, School of Medicine, Xinhua Hospital, Shanghai Jiaotong University, Shanghai, 200092, China.
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