A 3-stage redo ileal pouch-anal anastomosis significantly reduces pouch failure risk compared to a 2-stage approach.

• Redo pouch failure was 19.4% in the 3-stage group versus 32% in the 2-stage group (p=0.002).
• The 3-stage approach improved pouch survival (HR 0.68; p=0.04).

Consider initial rediversion for patients with septic complications to enhance outcomes.

• Septic indications increased the failure risk (HR 1.73; p=0.01).