While restoring the natural route of defecation, usually with improved quality of life and good long-term functional outcomes [33-35], IPAA may also be associated with various complications that, depending on duration of follow-up and diagnostic criteria, may occur in 10-60% of patients . Complications may appear early or late and may be surgical or medical. Of note, clear distinction between purely medical or surgical complications seems to be artificial. Several complications are a combination of the two and thus require the surgeon's, as well as the gastroenterolo-gist's, insight. Pouch dysfunction is the most frequent end result of a range of complications. Amongst the various complications reported that lead to pouch dysfunction are mechanical causes, functional disorders, pelvic sepsis and pouch inflammation. Systemic complications include new onset or persistent EIM as well as haematological, nutritional and electrolyte disturbances. The most dreaded condition, despite its rarity, is pouch and rectal-stump dysplasia or cancer . However, the most common and frustrating long-term consequence is pouch inflammation . A careful case selection is essential for a good outcome. Poor functional result or pouch failure are usually the end result of major unmanageable complications .
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