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Session: Quick Shot: IBD

QS127 - National Trends In J-Pouch Creation

Sunday, May 11, 2025
2:46 PM – 2:49 PM PT
Location: Room 9, Upper Level

    Quick Shot Presenter(s)

  • Alyssa Habermann, MD (she/her/hers)

    General Surgery Resident
    Virginia Commonwealth University
    Virginia Commonwealth University
    Richmond, VA, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • SR

    Stacy Ranson, MD

    Colorectal Surgeon
    VCU Health System
    Richmond, Virginia, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • SS

    Stephen P. Sharp, MD, FACS, FASCRS

    Assistant Professor of Surgery
    Virginia Commonwealth University
    Richmond, Virginia, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.
Alyssa Habermann, MD: This individual has no financial relationships with ineligible companies.
Stephen P. Sharp, MD, FACS, FASCRS: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: Largely due to advances in biologic therapy, the number of patients with ulcerative colitis (UC) who require surgical treatment with total proctocolectomy (TPC) and ileal pouch-anal anastomosis (IPAA) or J-pouch has decreased over time. We aim to understand how such advances have impacted volume of J-pouch creations over time.

Methods/Interventions: The NSQIP database from 2005-2022 was queried for all patients who underwent J-pouch creation. CPT codes included were 44157, 44156, 44211, and 45113. In order to compensate for the increasing number of participating institutions in the database and total recorded cases over time, the following outcomes were recorded: total number of J-pouch creations, percentage of J-pouch creations compared to total number of recorded surgeries, and ratio of J-pouch creations to number of participating institutions. Spearman rank correlation was used to determine correlation strength of each of these outcomes with time. Furthermore, the NSQIP years were split into equal length eras and ANOVA analysis was performed to assess for differences in number of J-pouch creations performed between eras.

Results/Outcomes: There has been a significant decrease in percentage of J-pouch creations compared to total number of recorded surgeries (p < 0.001) (Figure 1) and ratio of J-pouch creations to number of participating institutions (p < 0.001) (Figure 2). When divided into early, middle, and late eras, there was a significant difference in percentage of J-pouch creations compared to total number of recorded surgeries (p < 0.001 to 0.009) and ratio of J-pouch creations to number of participating institutions ( < 0.001 to 0.014) when each era is compared to the other two.

Conclusion/Discussion: Even when compensating for the increase in number of participating institutions and total number of recorded cases, there has been a significant decrease in number of J-pouch creations performed over time. This has the potential to impact trainee case numbers and surgical education.