Citations 2
P0762 Defining Quality Pouch Surgery – A Critical Step Towards Centralization? International Consensus on Key Performance Indicators in Pouch Surgery (KPIPS) Study
Holubar, S, Soop, M., Poskus, T, Neary, P, Uchino, Tairin , Yang, S S, Adamina, M, Avellaneda, N L, Barnes, E, Brouquet, A, Brown, S R, Overstraeten, A De Buck Van, Buskens, C J, Chiorean, Michael , Clark, D, Cohen, B, Ouali, S El, Faiz, O D, Hahnloser, Dieter, Hancock, L, Herfarth, H, Johnston, M, Kayal, M, Laharie, D, Liberman, S, Loftus, E, Moeslein, G, Myrelid, P, Qazi, Taha , Raffals, L, Rubin, D T, Spinelli, A, Steinhagen, Emily , Verstock, Bram, Warusavitarne, J, Wexner, S, Winter, D, Group, KPIPS Study, Verstockt, Bram , Clark, David A. , Verstockt, B , Holubar, Stefan D. , Poškus, Tomas , Neary, Peter, Brouquet, Antoine , Overstraeten, Anthony de Buck van , Buskens, Christianne Johanna , Ouali, Sara El , Faiz, Omar , Fichera, Alessandro , Hahnloser, Dieter , Herfarth, Hans , Kayal, Maia , Laharie, David , Liberman, Sender A., Myrelid, Pär , Poylin, Vitaliy Y. , Raffals, Laura E. , Spinelli, A, Tozer, Phil J. , Wexner, Steven D
Journal of Crohn’s and Colitis | January 21, 2026 | Volume: 20 | Issue: Supplement_1 | Pages: No page available
Abstract Background Global data demonstrate an inverse relationship between hospital ileoanal pouch volume and adverse outcomes, highlighting the need for quality metrics for this technically demanding procedure.1-4 Currently, there are no standardised quality indicators to define high-quality pouch surgery. This study aimed to establish international consensus on key performance indicators (KPIs) in pouch surgery. Methods A modified Delphi process was conducted among an international, multidisciplinary panel of experts. Participants were identified through professional networks, literature review, and direct email invitation; additional participants recruited via a snowball sampling approach over one month. Candidate KPIs were generated from literature review and expert input across 5 domains. Each item was rated on a 9-point Likert scale (1 = not important, 9 = critically important); consensus was predefined as ≥ 80% of respondents rating an item 7–9. Items not reaching consensus were re-rated in a second round following anonymized group feedback. Results Round 1 included 312 participants from 37 countries. Demographics (Table 1): 53% were age 45 years, 35.2% were female, and included surgeons (68.6%) and gastroenterologists (31.1%). Most (76.6%) practice at academic or university hospitals, with a median of 11 (5–17) years in practise; 78.9% perform >1 pouchoscopy per month, and 39.5% of surgeons perform 5 pouches/year. Respondents’ regions included North America (51%), Europe (26%), Oceania (9%), Asia (6%), Latin America (4%), and the Middle East/Africa (4%). Seven (18%) countries (Denmark, Lithuania, Malaysia, Norway, United Arab Emirates, Sweden, and Switzerland) reported pouch surgery is already centralised, while 70.6% agreed pouch centralisation should be implemented. Cost/logistics and professional autonomy were the most important barriers to centralisation, whereas capacity and training exposure were least important. Overall, 37/59 (62.7%) candidate KPIs reached consensus after Round 1. The Round 2 response rate was 61%, and 2 additional KPIs reached consensus (preop ileitis and long-term risk of pouchitis). Additionally, 14 of 25 (56%) informed consent items reached consensus, and 64% of respondents felt informed consent for pouch surgery requires 2 or more office visits. Consensus items were used to populate a KPIPS Checklist (Figure 1). Conclusion Through an international Delphi process, the KPIPS study identified a consensus-derived set of key performance indicators to measure quality in pouch surgery. These quality metrics provide a foundation for benchmarking outcomes and represent a critical step towards centralization and the development of designated pouch centres of excellence to improve global standards of care for pouch patients. References: 1. Worley GHT, Fearnhead NS, Brown SR, et al. Review of current practice and outcomes following ileoanal pouch surgery: Lessons learned from the ileoanal pouch registry and the 2017 ileoanal pouch report. Colorectal Dis 2018;20:913–22. 2. Giddings HL, Yang PF, Steffens D, Solomon MJ, Ng KS. Influence of hospital-level and surgeon factors on the outcomes after ileo-anal pouch surgery for inflammatory bowel disease: Systematic review. Br J Surg 2024;111. 3. Hoang CM, Maykel JA, Davids JS, et al. Distribution of elective ileal pouch-anal anastomosis cases for ulcerative colitis: A study utilizing the university health system consortium database. J Gastrointest Surg 2020;24:2613–9. 4. Moojen TB, Visser E, Reijntjes MA, et al. One-year stoma-free survival of ileoanal pouches for uc in european centers: The miracle project. Ann Surg Open 2025;6:e596. Conflict of interest: Prof. Holubar, Stefan: No conflict of interest Soop, Mattias: No conflict of interest Poskus, Tomas: No conflict of interest Neary, Peter: No conflict of interest Uchino, Tairin: No conflict of interest Yang, Song-soo: No conflict of interest Adamina, Michel: No conflict of interest Avellaneda, Nicolas Luis: No conflict of interest Barnes, Edward: No conflict of interest Brouquet, Antoine: No conflict of interest Brown, Steven Ross: No conflict of interest De Buck Van Overstraeten, Anthony: No conflict of interest Buskens, Christianne J.: No conflict of interest Chiorean, Michael: No conflict of interest Clark, David: No conflict of interest Cohen, Benjamin: No conflict of interest El Ouali, Sara: No conflict of interest Faiz, Omar Darius: No conflict of interest Fichera, Alessandro: No conflict of interest Hahnloser, Dieter: No conflict of interest Hancock, Laura: No conflict of interest Herfarth, Hans: No conflict of interest Johnston, Michael: No conflict of interest Kayal, Maia: No conflict of interest Laharie, David: No conflict of interest Liberman, Sender: No conflict of interest Loftus, Jr, Edward: No conflict of interest Moeslein, Gabriela: No conflict of interest Myrelid, Pär: No conflict of interest Poylin, Vitaliy: No conflict of interest Qazi, Taha: No conflict of interest Raffals, Laura: No conflict of interest Rubin, David T.: No conflict of interest Spinelli, Antonino: No conflict of interest Steinhagen, Emily: No conflict of interest Tozer, Philip: No conflict of interest Verstockt, Bram: No conflict of interest Warusavitarne, Janindra: No conflict of interest Wexner, Steven: No conflict of interest Winter, Desmond: No conflict of interest
Characteristics of Early-Onset vs Late-Onset Colorectal Cancer
Collaborative, REACCT, Zaborowski, Alexandra , Abdile, Ahmed, Adamina, Michel , Aigner, Felix , d’Allens, Laura, Allmer, Caterina, Álvarez, Andrea, Anula, Rocío, Atallah, S. , Bach, Simon P. , Barussaud, Marie, Baušys, Augustinas , Bebington, Brendan , Beggs, Andrew D. , Bellolio, Felipe, Bennett, Melissa-Rose , Berdinskikh, Anton, Bevan, Vicki, Bislenghi, Gabriele , Bludau, Marc , Boutall, Adam , Brouwer, Nelleke P.M. , Bruns, Christiane J. , Burger, Jacobus W. A. , Бурлов, Никита , Campanelli, Michela , Capdepont, Maylis, Carvello, Michele , Chew, Hwee-Hoon, Christoforidis, Dimitri, Clark, David A. , Climent, Marta, Cologne, Kyle G. , Contreras, Tomás, Croner, Roland S. , Daniels, I. R. , Delrio, Paolo , Deutsch, Michael , D’Hoore, André , Drozdov, E. S. , Duek, Daniel, Dunlop, Malcolm G. , Edmundson, Aleksandra , Efetov, Sergey , El‐Hussuna, Alaa , Elliot, Brodie, Espín, Eloy , Faes, Seraina , Faiz, Omar , Frasson, Matteo , Figueiredo, Nuno , Forgan, Tim , Frizelle, Frank , Gadaev, Shamil, Gellona, José, Glyn, Tamara , Gong, Jianping, Barisic, Goran, Greenwood, Emma, Guren, Marianne G. , Guillon, Stephanie, Gutlic, Ida , Hanly, Ann, Hasegawa, Hirotoshi , Iversen, Lene Hjerrild , Hill, James , Hoch, Jiří, Hoffmeister, Michael , Hompes, Roel , Hurtado‐Pardo, Luis , Iaquinandi, Fabiano , Imbrasaitė, Ugnė , Jafari, Mehrenah Dorna, Kanemitsu, Yukihide , Karimuddin, Ahmer , Keller, Deborah S. , Kelly, Justin, Kennelly, Rory , Khrykov, Gleb , Kocián, Petr , Koh, Cherry , Kok, N. F. M., Knight, Katrina , Knol, Joep, Kontovounisios, Christos , Kørner, Hartwig , Kronberger, Irmgard, Kroon, Hidde M. , Kural, Said , Lakkis, Zaher , Lankov, Timur , Larson, Dave, Lázár, György , Lee, Kai-Yin , Lepistö, Anna , Loi, Lynette , Lynch, Craig, Maillou‐Martinaud, Helene, Maroli, Annalisa , Martling, Anna , Matzel, Klaus E. , Mayol, Julio , McDermott, Frank , Meurette, G. , Mitteregger, Martin , Моисеенко, А С, Monson, John R.T. , Moritani, Konosuke , Munini, Martino , Nahas, Caio Sérgio Rizkallah , Negoi, Ionuţ , Novikova, A , Ocares, Misael, Olkina, Alexandra, Oñate‐Ocaña, Luis F. , Otero, Jaime, Özen, Cihan , Pace, Ugo , Julião, Guilherme Pagin São , Panaiotti, Lidiia , Panís, Yves , Papamichael, Demetris , Uriburu, Juan C Patrón , Pera, Miguél , Perez, Rodrigo Oliva , Pfeffer, F. , Phang, P. Terry , Poškus, Tomas , Pringle, Heather , Proud, David , Raguz, Ivana , Rama, N. , Rasheed, Shahnawaz, Raval, Manoj J. , Reißfelder, Christoph , Meneses, Juan Carlos Reyes , Ris, Frédéric , Riss, Stefan , Rodríguez‐Zentner, Homero , Saklani, Avanish , Salido, Andrea Jiménez, Sammour, Tarik , Saraste, Deborah , Schneider, Martin , Seishima, Ryo , Sekulic, Aleksander , Seppälä, Toni T. , Sheahan, Kieran , Shine, Rebecca , Shlomina, Alexandra , Sica, Guiseppe S., Singnomklao, T, Siragusa, Leandro , Spinelli, Antonino , Staiger, Roxane D. , Stamos, Michael J. , Sunderland, Michael, Tan, Ker‐Kan , Tanis, Pieter J. , Tekkis, Paris, Teklay, Biniam, Tengku, Sabrina , Jiménez‐Toscano, Marta , Turina, Matthias , Ulrich, Alexis , Vailati, Bruna Borba , Harten, Meike van, Warrier, Satish K. , Wexner, Steve, Wilt, Hans De, Xynos, Evangelos , You, Nancy, Zakharenko, Alexander, Zeballos, Justino, Winter, D. C. , Wexner, Steven D. , Hoffmeister, Michael , Seppälä, Toni T , Spinelli, Antonino , Wexner, Steven D , Ris, Frederic , Collaborative, REACCT, Andric, Mihailo , Bala, Miklosh , Biondo, Sebastiano , Brown, Carl James , Buchanan, Daniel D. , Buchwald, Pamela , Dapri, Giovanni , Davies, Justin , Denost, Quentin , Dias, André Roncon , Dziki, Adam Janusz , Emile, Sameh Hany , Evans, Martyn D. , Fleming, Fergal J. , Foppa, Caterina , Fowler, G , Gong, Jianping, Greenwood, Emma, Hahnloser, Dieter , Hampel, Heather , Hill, Andrew Graham , Islam, Rumana, Jafari, Mehrenah D, Карачун, А. М. , Krivokapić, Zoran , Kryžauskas, Marius , Kusters, Miranda , Lee, Suk-Hwan , Lefèvre, Jérémie H. , Lieu, Christopher H. , Martin, Sean, Millán, Mónica , Morărașu, Ștefan , Möslein, Gabriela , Nahas, Sérgio Carlos , Okabayashi, Koji , Олькина, Александра Юрьевна , Park, Jason , Patel, Swati , Petrov, Alexei, Rega, Daniela , Roxburgh, Campbell S.D. , Smart, Neil James , Solis, Alejandro, Steele, Scott R. , Владимирович, Царьков Петр , Verhoef, Cornelis , Weinberg, Benjamin A. , Wells, Cameron I. , Wolthuis, Albert M.
JAMA Surgery | June 30, 2021 | Volume: 156 | Issue: 9 | Pages: 865