回肠储袋相关瘘（IAPRF）是回肠储袋-肛门吻合术后可能出现的并发症，显着影响储袋预后和患者的生活质量。本研究旨在进行全面的叙述性回顾，以更好地对 IAPRF 的流行病学、危险因素、病因、治疗和结果进行分类，并提出一种系统分类的算法。共确定了 10 项研究，涉及 664 名 IAPRF 患者，患病率范围为 4% 至 45%。报告的瘘管类型如下：储袋阴道瘘（n = 236，35.5%）、会阴部瘘（n = 139，21%）、肠皮瘘（n = 54，8%）、储袋肛门瘘（n = 53，8%） )、骶前 (n = 18, 2%) 和吻合 (n = 15, 2%)。 21%-37.2%的患者发生术后盆腔脓毒症。另外 20 项关于瘘管分类的研究根据发病时间和病因将其分为 5 类：吻合相关、手术技术方面、克罗恩病样储袋炎症、隐腺性和恶性肿瘤。据报道，高达 70% 的患者接受了储袋切除术。与吻合口并发症、技术性手术问题和隐腺瘘相关的瘘管需要手术治疗。另一方面，与炎症相关的瘘管优先使用生物制剂或小分子治疗。© 作者 2024。由牛津大学出版社代表克罗恩病出版

Ileoanal pouch-related fistula (IAPRF) is a possible complication after ileal pouch-anal anastomosis that significantly impacts pouch prognosis and the patient's quality of life. This study aimed to perform a comprehensive narrative review to better classify the epidemiology, risk factors, etiology, management, and outcomes of IAPRF, and to propose an algorithm for its systematic classification. Ten studies comprising 664 patients with IAPRF were identified, with a prevalence ranging from 4% to 45%. The reported fistula types were as follows: pouch-vaginal (n = 236, 35.5%), perineal (n = 139, 21%), enterocutaneous (n = 54, 8%), pouch-anal (n = 53, 8%), presacral (n = 18, 2%), and anastomotic (n = 15, 2%). Postsurgical pelvic sepsis occurred in 21%-37.2% of patients. Twenty additional studies regarding fistula classification divided them according to onset time and etiology, defining 5 categories: anastomotic-related, technical aspects of the surgery, Crohn's disease-like pouch inflammation, cryptoglandular, and malignancy. Pouch excision was reported in up to 70% of patients. Fistulas associated with anastomotic complications, technical surgical issues, and cryptoglandular fistulas warrant surgical management. On the other hand, fistulas associated with inflammation are preferentially managed with biologics or small molecules.© The Author(s) 2024. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.