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News
Patients with diverted ileal pouches face tougher odds — more severe strictures and frequent pouchitis — but endoscopic stricturotomy still gets the job done. A new study found a 95.2% technical success rate in diverted pouches, matching outcomes in nondiverted patients, with no perforations, bleeding, or deaths across 123 procedures. Researchers say the findings support endoscopic treatment as a first-line option before turning to surgery.
Patients with diverted ileal pouches after ileal pouch-anal anastomosis (IPAA) tend to have more severe disease — but a new study shows that endoscopic stricturotomy can handle it just as effectively. Researchers at Columbia University Irving Medical Center compared outcomes in 12 patients with diverted pouches and 42 with nondiverted pouches, all of whom underwent the procedure for distal pouch or anastomotic strictures between 2020 and 2026.
Despite the diverted group presenting with far more severe strictures and a 75% rate of concurrent diversion pouchitis, the overall technical success rate across 123 procedures was an impressive 98.4% — with no significant difference between groups. Surgical intervention rates were also similar (25% vs. 21%), and no perforations, bleeding, or deaths occurred in either group.
By the Numbers:
Why it matters: These findings support endoscopic stricturotomy as a viable, safe first-line option for diverted pouch strictures — potentially sparing patients from more invasive surgeries like pouch excision and opening the door to ileostomy closure and restored bowel continuity.
