What is the evidence for IPAA over total colectomy in indeterminate colitis, given conflicting reports on long-term functional outcomes

What is known

- Several cohort studies report that functional outcomes, quality of life, and pouch survival after ileal pouch-anal anastomosis (IPAA) can be equivalent or similar between indeterminate colitis and ulcerative colitis patients. ^1–3

What is unknown / caveats

- The retrieved excerpts do not contain a direct comparison of IPAA against total colectomy (without reconstruction) in indeterminate colitis, so they cannot establish that one is preferable to the other. - The advisability of IPAA in indeterminate colitis is described as debated, with conflicting long-term reports. ^4,5

## References

1. Nicholls RJ, Wells AD. Indeterminate colitis. Baillieres Clin Gastroenterol. 1992;6(1):105-12. PMID: 1586764.

2. Lopez NE, Zaghyian K, Fleshner P. Is There a Role for Ileal Pouch Anal Anastomosis in Crohn's Disease?. Clin Colon Rectal Surg. 2019;32(4):280-290. PMID: 31275075.

3. Angriman I, Colangelo A, Mescoli C, Fassan M, D'Incà R, Savarino E, Pucciarelli S, Bardini R, Ruffolo C, Scarpa M. Validation of the Padova Prognostic Score for Colitis in Predicting Long-Term Outcome After Restorative Proctocolectomy. Front Surg. 2022;9:911044. PMID: 35959125.

4. Netz U, Galbraith NJ, O'Brien S, Carter J, Manek S, Petras RE, Galandiuk S. Long-term outcomes following ileal pouch-anal anastomosis in patients with indeterminate colitis. Surgery. 2018;163(3):535-541. PMID: 29325789.

5. McIntyre PB, Pemberton JH, Wolff BG, Dozois RR, Beart RW J. Indeterminate colitis. Long-term outcome in patients after ileal pouch-anal anastomosis. Dis Colon Rectum. 1995;38(1):51-4. PMID: 7813345.

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_Draft, generated by the IBDology RAG and not yet clinician-reviewed. Answers are grounded in the retrieved literature listed above; a high faithfulness score means the answer matches its sources, not that the sources are correct._