Management of pouch neoplasia: consensus guidelines from the International Ileal Pouch Consortium

Ravi P. Kiran, Gursimran S. Kochhar, Revital Kariv, Douglas K. Rex, Akira Sugita, David T. Rubin, Udayakumar Navaneethan, Tracy L. Hull, Huaibin Mabel Ko, Xiuli Liu, Lisa A. Kachnic, Scott Strong, Marietta Iacucci, Willem Bemelman, Philip Fleshner, Rachael A. Safyan, Paulo G. Kotze, André D'Hoore, Omar Faiz, Simon LoJean H. Ashburn, Antonino Spinelli, Charles N. Bernstein, Sunanda V. Kane, Raymond K. Cross, Jason Schairer, James T. McCormick, Francis A. Farraye, Shannon Chang, Ellen J. Scherl, David A. Schwartz, David H. Bruining, Jessica Philpott, Stuart Bentley-Hibbert, Dino Tarabar, Sandra El-Hachem, William J. Sandborn, Mark S. Silverberg, Darrell S. Pardi, James M. Church, Bo Shen*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations


Surveillance pouchoscopy is recommended for patients with restorative proctocolectomy with ileal pouch–anal anastomosis in ulcerative colitis or familial adenomatous polyposis, with the surveillance interval depending on the risk of neoplasia. Neoplasia in patients with ileal pouches mainly have a glandular source and less often are of squamous cell origin. Various grades of neoplasia can occur in the prepouch ileum, pouch body, rectal cuff, anal transition zone, anus, or perianal skin. The main treatment modalities are endoscopic polypectomy, endoscopic ablation, endoscopic mucosal resection, endoscopic submucosal dissection, surgical local excision, surgical circumferential resection and re-anastomosis, and pouch excision. The choice of the treatment modality is determined by the grade, location, size, and features of neoplastic lesions, along with patients' risk of neoplasia and comorbidities, and local endoscopic and surgical expertise.

Original languageEnglish (US)
Pages (from-to)871-893
Number of pages23
JournalThe Lancet Gastroenterology and Hepatology
Issue number9
StatePublished - Sep 2022

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


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