回肠袋肛门吻合术（IPAA）是炎症性肠病（IBD）患者在需要结肠切除后恢复手术的标准程序。然而，切除病变结肠并不能消除袋内肿瘤的风险。我们旨在评估IPAA后IBD患者袋内肿瘤的发生率。通过临床记录搜索，从1981年1月至2020年2月，筛选使用IBD的第9/第10版国际疾病分类代码接受IPAA和随后的小肠镜检查的病人。收集相关人口统计学、临床、内镜和组织学数据。共纳入1319名病人（43.9%女性），大多数为溃疡性结肠炎（95.2%）。在1319名患者中，10例（0.8%）在IPAA后出现肿瘤。肿瘤发生在袋子中的4例患者，其中肿瘤发生在袖套或直肠中的5例患者，还有1例患者的袋前、袋内和袖套都有肿瘤。肿瘤类型包括低级别上皮内瘤变（n = 7）、高级别上皮内瘤变（n = 1）、结直肠癌（n = 1）和粘膜相关淋巴组织瘤（n = 1）。结肠广泛性炎症、原发性硬化性胆管炎、回流性末端小肠炎和IPAA时的直肠上皮内瘤变都与袋内肿瘤的风险显著相关。IPAA后IBD患者袋内肿瘤的发生率相对较低。IPAA前结肠广泛性炎症、原发性硬化性胆管炎和回流性末端小肠炎和IPAA时的直肠上皮内瘤变会显著提高袋内肿瘤的风险。即使有结直肠肿瘤的病人，在IPAA后也可以采取有限的监测计划。

Ileal pouch-anal anastomosis (IPAA) is the standard restorative procedure following proctocolectomy in patients with inflammatory bowel disease (IBD) who require colectomy. However, removal of the diseased colon does not eliminate the risk of pouch neoplasia. We aimed to assess the incidence of pouch neoplasia in IBD patients following IPAA.All patients at a large tertiary center with International Classification of Diseases-Ninth Revision/International Classification of Diseases-Tenth Revision codes for IBD who underwent IPAA and had subsequent pouchoscopy were identified using a clinical notes search from January 1981 to February 2020. Relevant demographic, clinical, endoscopic, and histologic data were abstracted.In total, 1319 patients were included (43.9% women). Most had ulcerative colitis (95.2%). Out of 1319 patients, 10 (0.8%) developed neoplasia following IPAA. Neoplasia of the pouch was seen in 4 cases with neoplasia of the cuff or rectum seen in 5 cases. One patient had neoplasia of the prepouch, pouch, and cuff. Types of neoplasia included low-grade dysplasia (n = 7), high-grade dysplasia (n = 1), colorectal cancer (n = 1), and mucosa-associated lymphoid tissue lymphoma (n = 1). Presence of extensive colitis, primary sclerosing cholangitis, backwash ileitis, and rectal dysplasia at the time of IPAA were significantly associated with increased risk of pouch neoplasia.The incidence of pouch neoplasia in IBD patients who have undergone IPAA is relatively low. Extensive colitis, primary sclerosing cholangitis, and backwash ileitis prior to IPAA and rectal dysplasia at the time of IPAA raise the risk of pouch neoplasia significantly. A limited surveillance program might be appropriate for patients with IPAA even with a history of colorectal neoplasia.© The Author(s) 2023. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.