Social Media Influences Redo Pouch Surgery Referral More Than Index Surgeons

Abstract

Introduction: Redo ileal pouch anal anastomosis (IPAA), the procedure of choice for IPAA, is mainly attempted in specialized centers but referral patterns for redo IPAA are not well known. Social media may be a valuable tool for patients to find surgeons. In our study we evaluated referral patterns of redo IPAA. Methods: All redo IPAA procedures performed at our center for IPAA failure between 09/2016 and 02/2022 were included. Patient demographics, disease characteristics and referral patterns were reported. Results: A total of 141 patients with IPAA failure who had redo IPAA surgery were included. The median age was 40 years. The median time between the index surgery and the redo surgery was 5 years (interquartile range: 2-11). There were 108 ulcerative colitis, 25 indeterminate colitis and 8 familial adenomatous polyposis patients. Referrals for 49 patients were via social media or word of mouth (33.1%), 48 were referred by gastroenterologists (32.4%), 33 by colorectal surgeons (22.3%) and 1 by an oncologist (0.7%). The index case was done by our team in 11 patients (7.4%). A significant majority of patients, 30%, were from outside of our center’s tristate area. Conclusion: Social media and patient-patient interaction was the number one referral source, followed closely by the gastroenterologists. The small number of referrals by the primary surgeon is a source of concern since the majority of redo IPAAs are done to fix surgical failures.