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Ileal pouch

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https://www.readbyqxmd.com/read/28542114/predictors-of-pouchitis-after-ileal-pouch-anal-anastomosis-in-pediatric-onset-ulcerative-colitis
#1
Firas Rinawi, Amit Assa, Rami Eliakim, Yael Mozer Glassberg, Vered Nachmias Friedler, Yaron Niv, Yoram Rosenbach, Ari Silbermintz, Noam Zevit, Raanan Shamir
OBJECTIVES: Few studies have reported on the incidence and risk factors for pouchitis following colectomy and ileal pouch-anal anastomosis (IPAA) in patients with pediatric-onset ulcerative colitis (UC). We aimed to determine clinical predictors for the development of pouchitis following IPAA in this population. PATIENTS AND METHODS: We performed a retrospective chart review of all pediatric UC cases that were diagnosed at the Schneider Children's Medical Center of Israel between 1981 and 2013 and who underwent colectomy during disease course...
May 24, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28534070/total-abdominal-colectomy-vs-restorative-total-proctocolectomy-as-the-initial-approach-to-medically-refractory-ulcerative-colitis
#2
Jinyu Gu, Luca Stocchi, Jeanie Ashburn, Feza H Remzi
PURPOSE: There is scant data assessing the consequences of staging restorative proctocolectomy for ulcerative colitis. The aim of the study is to compare outcomes of initial vs. staged restorative proctocolectomy. METHODS: Patients completing restorative proctocolectomy, including ileostomy reversal, during 2006-2012 were identified from an IRB-approved database. Demographics, treatment variables, and perioperative outcomes were assessed. RESULTS: Out of 521 patients, 322 (62%) underwent initial total abdominal colectomy before restorative proctectomy...
May 22, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28501251/dysplasia-and-cancer-in-inflammatory-bowel-disease
#3
REVIEW
Lyen C Huang, Amit Merchea
Inflammatory bowel disease is associated with an increased risk of dysplasia and cancer. Improvements in medical management and endoscopic surveillance have reduced these risks. Patients can develop cancer even in the absence of dysplasia or with indefinite or low-grade dysplasia. Most guidelines recommend starting surveillance colonoscopy 6 to 10 years after initial diagnosis with interval surveillance afterward every 1 to 5 years depending on risk and/or individual characteristics. Most patients should undergo total proctocolectomy with end ileostomy or reconstruction with ileal pouch anal anastomosis because segmental and subtotal resections carry a higher risk of metachronous cancers...
June 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28486255/intestinal-barrier-disruption-in-ileal-pouchitis-after-ileal-pouch-anal-anastomosis-in-a-rat-model
#4
Kai-Yu Li, Jian-Lin Wang, Yan-Yan Xu, Sen-Yang Gao, Ying-Ying Zhang, An-Qi He, Gang Liu
BACKGROUND: Pouchitis occurs in approximately 50% of patients with ulcerative colitis after ileal pouch-anal anastomosis (IPAA) but the pathogenesis remains unclear. We used a rat model of dextran sulfate sodium (DSS)-induced ileal pouchitis to examine whether intestinal barrier disruption plays a role in the development and progression of the disease. METHODS: Rats were randomly divided into DSS (underwent IPAA and administered 5% DSS orally), IPAA (underwent IPAA), and Sham groups (underwent switch abdominal surgery)...
May 5, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28485190/complications-and-morbidity-associated-with-loop-ileostomies-in-patients-with-ulcerative-colitis
#5
J Park, B Gessler, M Block, E Angenete
BACKGROUND AND AIMS: Loop ileostomies are frequently used as diversion of the fecal stream to protect a distal anastomosis. The aim of this study was to identify complications and morbidity related to loop ileostomies in patients with ulcerative colitis at a nonemergent setting. MATERIAL AND METHODS: Consecutive patients with ulcerative colitis who received a loop ileostomy at a tertiary referral center in Sweden from January 2006 until December 2012 were included and studied retrospectively...
May 1, 2017: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/28481854/paradoxical-impact-of-ileal-pouch-anal-anastomosis-on-male-and-female-fertility-in-patients-with-ulcerative-colitis
#6
Frederik R Pachler, Søren B Brandsborg, Søren Laurberg
BACKGROUND: Birth rates in males with ulcerative colitis and ileal pouch-anal anastomosis have not been studied. OBJECTIVE: This study aimed to estimate birth rates in males and females with ulcerative colitis and study the impact of ileal pouch-anal anastomosis. DESIGN: This was a retrospective registry-based cohort study that was performed over a 30-year period. SETTINGS: Records for parenting a child from the same period were cross-linked with patient records, and birth rates were calculated using 15 through 49 years as age limits...
June 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28481467/restorative-proctocolectomy-an-example-of-how-surgery-evolves-in-response-to-paradigm-shifts-in-care
#7
Feza H Remzi, Olga A Lavryk, Jean H Ashburn, Tracy L Hull, Ian C Lavery, David W Dietz, Hermann Kessler, James M Church
BACKGROUND: Surgical technique constantly evolves in response to the pressure of progress. Ileal pouch anal anastomosis (IPAA) is a good example. We analyzed the effect of changes in practice on the technique of IPAA and its outcomes. METHODS: Patients undergoing primary IPAA at this institution were divided into three groups by date of IPAA: those operated from 1983-1993, 1994-2004, and 2005 - 2015. Demographics, patient comorbidity, surgical techniques, post-operative outcomes, pouch function and quality of life were analyzed...
May 8, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28477064/-the-technique-of-restorative-proctocolectomy-with-ileal-j%C3%A2-pouch-standards-and-controversies
#8
REVIEW
J Hardt, P Kienle
BACKGROUND: Restorative proctocolectomy (RPC) is the standard of care in the case of medically refractory disease and in neoplasia in ulcerative colitis (UC). OBJECTIVES: This review aims at providing an overview of the current evidence on standards, innovations, and controversies with regard to the surgical technique of RPC. RESULTS: RPC is the standard of care in the surgical management of UC refractory to medical treatment and in neoplasia...
May 5, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28470559/functional-outcomes-following-laparoscopic-ileal-pouch-anal-anastomosis-in-patients-with-chronic-ulcerative-colitis-long-term-follow-up-of-a-case-matched-study
#9
Se-Jin Baek, Amy L Lightner, Sarah Y Boostrom, Kellie L Mathis, Robert R Cima, John H Pemberton, David W Larson, Eric J Dozois
BACKGROUND: Laparoscopic ileal pouch-anal anastomosis (L-IPAA) has been increasingly adopted over the last decade due to short-term patient-related benefits. Several studies have shown L-IPAA to be equivalent to open IPAA in terms of safety and short-term outcomes. However, few L-IPAA studies have examined long-term functional outcomes. We aimed to evaluate the long-term functional outcomes of L-IPAA as compared to open IPAA. METHODS: A previous case-matched cohort study at our institution compared short-term outcomes between L-IPAA and open IPAA from 1998 to 2004...
May 3, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28462237/endoscopic-fistulotomy-heals-a-y-shaped-entero-entero-cutaneous-fistula
#10
Helen Lee, Bo Shen
Patients may develop fistulas due to Crohn's disease or as a postoperative complication after restorative proctocolectomy with ileal pouch anal anastomosis. Unfortunately, the treatment of fistulas can be challenging. The current standard of care may include medical therapy and/or surgical intervention. However, endoscopic treatment for postoperative pouch complications has emerged as a valid alternative option. We describe a case of persistent drainage from a Y-shaped entero-entero-cutaneous fistula that resolved after endoscopic fistulotomy with needle knife...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28456541/long-term-health-related-quality-of-life-outcomes-following-radical-cystectomy
#11
Paul T Gellhaus, Clint Cary, Hristos Z Kaimakliotis, Cynthia S Johnson, Michael Weiner, Michael O Koch, Richard Bihrle
OBJECTIVE: To evaluate the long-term (>5 years) health-related quality of life outcomes following radical cystectomy, comparing Indiana pouch (IP), neobladder (NB), and ileal conduit (IC). MATERIALS AND METHODS: The departmental radical cystectomy database was queried to identify patients who underwent radical cystectomy and urinary diversion for bladder cancer between 1991 and 2009 and had not died. Three hundred patients were identified and sent the validated Bladder Cancer Index (BCI) instrument...
April 26, 2017: Urology
https://www.readbyqxmd.com/read/28426474/pouch-related-symptoms-and-quality-of-life-in-patients-with-ileal-pouch-anal-anastomosis
#12
Edward L Barnes, Hans H Herfarth, Robert S Sandler, Wenli Chen, Elizabeth Jaeger, Van M Nguyen, Amber R Robb, Michael D Kappelman, Christopher F Martin, Millie D Long
BACKGROUND: Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) has become the standard surgical treatment for the majority of patients with inflammatory bowel disease (IBD) who require colectomy. We evaluated the prevalence of pouch-related symptoms among the Crohn's and Colitis Foundation of America Partners cohort and the effect of pouch-related symptoms on Patient-Reported Outcome Measurement Information System measures. METHODS: We performed analyses nested in the Crohn's and Colitis Foundation of America Partners cohort...
April 19, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28426453/indications-for-mode-of-delivery-in-pregnant-women-with-inflammatory-bowel-disease
#13
Kristin E Burke, Miriam J Haviland, Michele R Hacker, Scott A Shainker, Adam S Cheifetz
BACKGROUND: Reasons for the increased incidence of cesarean delivery among women with inflammatory bowel disease remain unclear. We assessed cesarean delivery incidence and factors influencing mode of delivery in women with inflammatory bowel disease. METHODS: We performed a 10-year retrospective cohort study of nulliparous women who delivered a singleton infant at our institution. We compared the risk of each mode of delivery in women with Crohn's disease and ulcerative colitis with women without inflammatory bowel disease...
May 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28426452/defining-the-most-appropriate-delivery-mode-in-women-with-inflammatory-bowel-disease-a-systematic-review
#14
Arthur Foulon, Jean-Louis Dupas, Charles Sabbagh, Julien Chevreau, Lionel Rebibo, Franck Brazier, Guillaume Bouguen, Jean Gondry, Mathurin Fumery
INTRODUCTION: High cesarean section (CS) rates are observed in patients with inflammatory bowel disease (IBD), but limited data are available to support this decision. We conducted a comprehensive review to evaluate the most appropriate mode of delivery in women with IBD according to disease phenotype and activity, as well as surgical history. MATERIALS AND METHODS: We searched MEDLINE (source PubMed) and international conference abstracts, and included all studies that evaluated digestive outcome after delivery in patients with IBD...
May 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28411100/w-pouch-with-modified-non-isolated-extra-limb-for-continence-in-cutaneous-diversion-after-radical-cystectomy
#15
Khaled M Abd Elwahab, Ahmed M Eliwa, Mohammed M Seleem, Maged M Ali, Islam M El-Babouly, Ahmed Ragab, Mohammed Naguib, Hamdy M Desouky, Esam A E Desoky, Mohammed Omran, Hussein M Kamel
OBJECTIVE: To report the functional results of continent cutaneous ileal urinary diversion using modified W-pouch with non-isolated extra limb for continence . PATIENTS & METHODS: From January 2013 to January 2016, 21 patients with muscle-invasive bladder cancer with with median (interquartile range) of 59 (56.5-62.5) years old underwent radical cystectomy with pelvic lymphadenectomy; they then had an ileal continent cutaneous pouch constructed from W-pouch with non-isolated extra limb for continence...
April 11, 2017: Urology
https://www.readbyqxmd.com/read/28410344/preoperative-clostridium-difficile-infection-does-not-affect-pouch-outcomes-in-patients-with-ulcerative-colitis-who-undergo-ileal-pouch-anal-anastomosis
#16
Amy L Lightner, Chung Sang Tse, Kevin Quinn, John R Bergquist, Felicity Enders, Richard Pendegraft, Sahil Khanna, Laura Raffals
BACKGROUND: The operation of choice for patients with chronic ulcerative colitis (CUC) is restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA). Pouchitis is the most common complication after IPAA. The incidence of Clostridium difficile infection (CDI) is higher in CUC patients than the general population and can lead to significant disease flares and higher rates of colectomy. We sought to determine the risk of pouchitis in patients with precolectomy CDI and 90-day postoperative IPAA complications...
April 13, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28405717/-differential-indications-for-ileoanal-pouch-anastomosis-ulcerative-colitis-familial-adenomatous-polyposis-synchronous-colorectal-cancer-crohn-s-disease-constipation
#17
A Fürst
Ileoanal pouch anastomosis is the procedure of choice for patients with drug refractory ulcerative colitis, indeterminate colitis and familial adenomatous polyposis (FAP). In selected patient groups this procedure is a treatment option for patients with Crohn's disease, hereditary nonpolyposis colorectal cancer (HNPCC), synchronous colorectal cancer and for severe colorectal constipation refractory to conservative drug treatment. The pouch procedure provides the opportunity to avoid a permanent ileostomy. The majority of surgeons prefer the ileal J‑pouch as the construction is the easiest to perform and complications and dysfunction rates are low...
April 12, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28394517/-technical-features-of-intestinal-ureteroplasty-art-6-simultaneous-ureteral-and-bladder-substitution
#18
B K Komyakov, A I Novikov, V A Ochelenko, B G Guliev, T Kh Al-Attar, M V Onoshko
AIM: To present the results and technical features of different methods of simultaneous ileal ureteral and bladder substitution. MATERIALS AND METHODS: From 2001 to 2016, 154 patients (mean age 52+/-9.2 years) underwent ileal and appendicular ureteroplasty. Of them, 70 (45.4%) were men and 84 (54.6%) women. Among them, 49 (31.8%) patients underwent ureteroplasty concurrently with orthotopic ileocystoplasty. The Studers ileal-ureter cystoplasty and Y-shaped bladder and ureteral reconstruction were performed in 38 (77...
April 2017: Urologii︠a︡
https://www.readbyqxmd.com/read/28387059/pouch-excision-indications-and-outcomes
#19
Amy L Lightner, Sheev Dattani, Eric J Dozois, Sara B Moncrief, John H Pemberton, Kellie L Mathis
INTRODUCTION: Resotrative proctolectomy (RPC) with Ileal-pouch anal anastomosis (IPAA) is the procedure of choice for ulcerative colitis. Unfortunately, up to 10% of pouches will fail, requiring either reconstruction or excision. While several series have reported on the aetiology of pouch failure, no study to date has focused on the postoperative complications associated with pouch excision. METHODS: Patients who had excision of ileoanal reservoir with ileostomy (CPT code 45136) were included...
April 7, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28383450/long-term-outcomes-after-continent-ileostomy-creation-in-patients-with-crohn-s-disease
#20
Erman Aytac, David W Dietz, Jean Ashburn, Feza H Remzi
BACKGROUND: Patients with Crohn's disease have a higher failure rate after ileal pouch surgery compared with their counterparts with ulcerative colitis. OBJECTIVE: We hypothesized that risk of continent ileostomy failure can be stratified based on the timing of Crohn's disease diagnosis and aimed to assess long-term outcomes. DESIGN: This was a retrospective cohort study. SETTINGS: The investigation took place in a high-volume, specialized colorectal surgery department...
May 2017: Diseases of the Colon and Rectum
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