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Ileal pouch

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https://www.readbyqxmd.com/read/28929216/refractory-pouchitis-improves-after-administration-of-the-green-tea-polyphenol-egcg-a-retrospective-review
#1
Minesh Mehta, Shifat Ahmed, Gerald Dryden
INTRODUCTION: Ulcerative colitis (UC) is a common, chronic, inflammatory process limited to the colon. UC affects up to 1 million individuals in the USA alone and requires resection in up to 30% of patients. Resection is often followed by creation of a pouch. Pouchitis is the most common complication of ileal pouch-anal anastomosis (IPAA) following total proctocolectomy, affecting up to 50% of patients. Symptoms include increased stool frequency, urgency, cramping, and bleeding. Management of pouchitis is complex in antibiotic refractory cases...
September 20, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28922254/obese-patients-undergoing-ileal-pouch-anal-anastomosis-short-and-long-term-surgical-outcomes
#2
Nicholas P McKenna, Kellie L Mathis, Mohammad A Khasawneh, Eric J Dozois, David W Larson, John H Pemberton, Amy L Lightner
BACKGROUND: Ileal pouch-anal anastomosis (IPAA) is the preferred surgical treatment for patients with chronic ulcerative colitis. Little is known about the impact of obesity on operative characteristics, short-term postoperative complications and long-term functional outcomes after IPAA. METHODS: A retrospective review of all patients undergoing IPAA for chronic ulcerative colitis at a single tertiary referral center between January 2002 and August 2013 was performed...
August 23, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28911880/pelvic-exenteration-for-gynecologic-malignancies-postoperative-complications-and-oncologic-outcomes
#3
A Romeo, M I Gonzalez, J Jaunarena, M E Zubieta, G Favre, J C Tejerizo
INTRODUCTION AND OBJECTIVE: To evaluate complications, morbidity and oncologic outcomes of pelvic exenteration as treatment for gynecologic malignancies. MATERIALS AND METHODS: Between 2008 and 2015, a total of 35 patients underwent pelvic exenteration, due to recurrence of gynecological cancer. Surgical outcomes, early and late postoperative complications, and recurrence/survival outcomes were assessed. RESULTS: Mean patient age was 53.8 years...
September 11, 2017: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/28884201/pouch-functional-outcomes-after-restorative-proctocolectomy-with-ileal-pouch-reconstruction-in-patients-with-ulcerative-colitis-japanese-multi-center-nationwide-cohort-study
#4
Motoi Uchino, Hiroki Ikeuchi, Akira Sugita, Kitaro Futami, Toshiaki Watanabe, Kouhei Fukushima, Kenji Tatsumi, Kazutaka Koganei, Hideaki Kimura, Keisuke Hata, Kenichi Takahashi, Kazuhiro Watanabe, Tsunekazu Mizushima, Yuji Funayama, Daijiro Higashi, Toshimitsu Araki, Masato Kusunoki, Takeshi Ueda, Fumikazu Koyama, Michio Itabashi, Riichiro Nezu, Yasuo Suzuki
BACKGROUND: Although several complications capable of causing pouch failure may develop after restorative proctocolectomy (RPC) for ulcerative colitis (UC), the incidences and causes are conflicting and vary according to country, race and institution. To avoid pouch failure, this study aimed to evaluate the rate of pouch failure and its risk factors in UC patients over the past decade via a nationwide cohort study. METHODS: We conducted a retrospective, observational, multicenter study that included 13 institutions in Japan...
September 7, 2017: Journal of Gastroenterology
https://www.readbyqxmd.com/read/28867978/when-not-to-pouch-important-considerations-for-patient-selection-for-ileal-pouch-anal-anastomosis
#5
Shannon Chang, Bo Shen, Feza Remzi
Ileal pouch-anal anastomosis (IPAA) is the preferred surgical treatment for patients who undergo colectomy and wish to avoid a permanent ileostomy. The overall outcomes are positive, with an improved quality of life and stable long-term pouch retention. However, certain conditions or disease states may be at a higher risk of pouch dysfunction or failure. For example, obese patients have an increased risk for postoperative complications. In addition, women with a history of obstetric complications and elderly patients with a history of sphincter damage or dysfunction may be at an increased risk for postoperative incontinence, although quality-of-life indices do not necessarily correlate with incontinence scores...
August 2017: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28858072/surgical-outcomes-in-vedolizumab-treated-patients-with-ulcerative-colitis
#6
Amy L Lightner, Nicholas P McKenna, Sara Moncrief, John H Pemberton, Laura E Raffals, Kellie L Mathis
BACKGROUND: Surgical outcomes and pouch outcomes in the setting of vedolizumab remains poorly understood. We sought to determine the rate of 30-day postoperative surgical infectious complications and pouch-specific complications among patients with ulcerative colitis (UC) who received vedolizumab within 12 weeks of surgery. METHODS: A retrospective chart review between 5/1/2014 and 12/31/2016 of all adult patients with UC who underwent an abdominal operation was performed...
August 29, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28852524/fecal-microbiota-transplantation-for-clostridium-difficile-infection-in-patients-with-ileal-pouches
#7
Nan Lan, Jean Ashburn, Bo Shen
Background:Clostridium difficile infection (CDI) in patients with ileal pouch-anal anastomosis (IPAA) has been increasingly recognized. The aim of this study was to evaluate the outcome of fecal microbiota transplantation (FMT) in patients with pouch and CDI. Methods: All consecutive patients that underwent FMT for CDI from 2012 to 2016 were extracted from our IRB-approved, prospectively maintained Registry of Pouch Disorders. The primary outcome was negative stool tests for Clostridium difficile after FMT and the secondary outcomes were symptomatic and endoscopic responses...
August 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28840472/thirty-day-hospital-readmission-after-restorative-proctocolectomy-and-ileal-pouch-anal-anastomosis-for-chronic-ulcerative-colitis-at-a-high-volume-center
#8
Nicholas P McKenna, Kellie L Mathis, Mohammad Khasawneh, Omair Shariq, Eric J Dozois, David W Larson, Amy L Lightner
BACKGROUND: Ileal pouch anal anastomosis (IPAA) is associated with a high 30-day hospital readmission rate. Risk factors and etiology of readmission remain poorly defined. We sought to determine the 30-day hospital readmission rate following IPAA at a high-volume center and identify any modifiable perioperative factors. METHODS: A retrospective review of all patients undergoing two- or three-stage IPAA for chronic ulcerative colitis at our institution between 2002 and 2013 was performed...
August 24, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28831607/prognostic-impact-of-hospital-volume-on-familial-adenomatous-polyposis-a-nationwide-multicenter-study
#9
Masahiro Tanaka, Yukihide Kanemitsu, Hideki Ueno, Hirotoshi Kobayashi, Tsuyoshi Konishi, Fumio Ishida, Tatsuro Yamaguchi, Takao Hinoi, Yasuhiro Inoue, Naohiro Tomita, Hideyuki Ishida, Kenichi Sugihara
PURPOSE: Many studies have shown that hospital volume is significantly associated with short- and long-term outcomes in various diseases, including cancer. However, there have been no reports discussing the relationship between hospital volume and familial adenomatous polyposis (FAP). This study aimed to clarify whether hospital volume affects short- and long-term outcomes in FAP patients. METHODS: We established a retrospectively collected database of FAP patients who underwent initial surgical treatment at 23 Japanese institutions during 2000-2012...
August 22, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28812104/-laparoscopic-proctocolectomy-technique-restorative-proctocolectomy-with-ileal-pouch-anal-anastomosis-in-ulcerative-colitis-video-article
#10
REVIEW
B Jansen-Winkeln, O Lyros, A Lachky, N Teich, I Gockel
Laparoscopic restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) constitutes a curative treatment option for therapy-refractory ulcerative colitis. A two-stage procedure with loop ileostomy at the time of IPAA is the most frequent variant of surgery. The aim of the procedure is the complete removal of the colon and rectum with simultaneous restoration of gastrointestinal continuity and preservation of continence functions. Long-term quality of life following laparoscopic proctocolectomy with IPAA is good and comparable with a healthy reference population...
August 15, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28765694/lactobacillus-acidophilus-alleviates-pouchitis-after-ileal-pouch-anal-anastomosis-in-rats
#11
Yan-Yan Xu, Ying-Ying Zhang, An-Qi He, Kai-Yu Li, Sen-Yang Gao, Gang Liu
AIM: To assess the therapeutic potential of Lactobacillus acidophilus (LA) for the treatment of pouchitis in a rat model. METHODS: Sprague Dawley rats underwent proctocolectomy and ileal pouch-anal anastomosis followed by administration of dextran sulfate sodium (DSS) to induce pouchitis. Rats with pouchitis were randomly divided into three groups: no intervention (NI), normal saline (NS, 3 mL/d normal saline for 7 d), and LA (3 mL/d LA at 1× 10(10) colony-forming units for 7 d)...
July 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28742696/transanal-versus-transabdominal-minimally-invasive-completion-proctectomy-with-ileal-pouch-anal-anastomosis-in-ulcerative-colitis-a-comparative-study
#12
Anthony de Buck van Overstraeten, Anders Mark-Christensen, Karin A Wasmann, Vivian P Bastiaenen, Christianne J Buskens, Albert M Wolthuis, Koen Vanbrabant, André D'hoore, Willem A Bemelman, Anders Tottrup, Pieter J Tanis
OBJECTIVE: This study aims to compare surgical outcome of transanal ileal pouch-anal anastomosis (ta-IPAA) with transabdominal minimal invasive approach in ulcerative colitis (UC), using the comprehensive complication index (CCI). BACKGROUND: Recent evolutions in rectal cancer surgery led to transanal dissection of the rectum resulting in a better exposure of the distal rectum and presumed better outcome. The same approach was introduced for patients with UC, resulting in decreased invasiveness...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28705784/laparoscopic-proctocolectomy-with-ileal-j-pouch-anal-anastomosis-in-children
#13
Ufuk Ateş, Ergun Ergün, Gülnur Göllü, Gönül Küçük, Aydın Yağmurlu
BACKGROUND/AIMS: We aimed to evaluate postoperative fecal incontinence scales of children who underwent laparoscopic proctocolectomy and ileal J-pouch anastomosis for familial adenomateous polyposis (FAP) and inflammatory bowel disease (IBD). MATERIALS AND METHODS: Fecal incontinence scores were collected at 3 months post-surgery. A retrospective chart review was also performed to obtain the demographic data and operative technical details. RESULTS: The postoperative Wexner Fecal Incontinence Score was 0 in 9 of 11 patients and satisfactory in the remaining two...
July 13, 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28695880/hand-assisted-laparoscopic-restorative-proctocolectomy-with-ileal-pouch-anal-anastomosis-for-ulcerative-colitis
#14
Pengcheng Zhu, Chungen Xing
INTRODUCTION: In this study, we aimed to evaluate the feasibility and safety of undergoing restorative proctocolectomy through ileal pouch-anal anastomosis (RPC-IPAA) with hand-assisted laparoscopic (HALS) in patients with ulcerative colitis (UC). PATIENTS AND METHODS: We reviewed 40 consecutive patients who underwent RPC-IPAA with HALS or open technique for treatment of UC between 2010 and 2013. Moreover, the intra-/post-operative outcomes were compared. RESULTS: We found the median operative time was significantly longer in the HALS group while the blood loss was significantly less in patients with HALS than with open surgery...
October 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28684935/the-role-of-temporary-fecal-diversion
#15
REVIEW
Amy L Lightner, John H Pemberton
The use of temporary fecal diversion is of great importance to tenuous anastomosis, immunosuppressed patient, or actively infected patient. Its use protects newly constructed intestinal anastomoses from being the culprit of pelvic sepsis or systemic illness. Thus, potential morbidity and mortality can be averted. However, its appropriate or optimal use is often debated. We herein discuss the evidence for when to best use a diverting stoma for colorectal, coloanal, and ileoanal anastomoses. We also discuss the importance of considering a temporary diverting stoma in the setting of high-dose immunosuppression (e...
July 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28667683/pouch-failures-following-ileal-pouch-anal-anastomosis-for-ulcerative-colitis
#16
Anders Mark-Christensen, Rune Erichsen, Søren Brandsborg, Frederik Rønne Pachler, Charlotte Buchard Nørager, Niels Johansen, Jørn Helmut Pachler, Ole Thorlacius-Ussing, Mie Dilling Kjaer, Niels Qvist, Louise Preisler, Jens Hillingsø, Jacob Rosenberg, Søren Laurberg
BACKGROUND: The ileal pouch-anal anastomosis is a procedure offered to patients with ulcerative colitis who opt for restoration of bowel continuity. The aim of this study was to determine the risk of pouch failure and ascertain risk factors associated with failure. METHOD: 1,991 patients with ulcerative colitis operated with ileal pouch-anal anastomosis in Denmark in the period 1980-2013 were included. Pouch failure was defined as excision of the pouch or presence of a stoma un-reversed within one year after its creation...
July 1, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28664652/laparoscopic-ileopexy-for-afferent-limb-syndrome-after-ileal-pouch-anal-anastomosis
#17
Yoshiki Okita, Toshimitsu Araki, Junichiro Hiro, Satoru Kondo, Hiroyuki Fujikawa, Shigeyuki Yoshiyama, Mikihiro Inoue, Yuji Toiyama, Minako Kobayashi, Masaki Ohi, Yasuhiro Inoue, Keiichi Uchida, Yasuhiko Mohri, Masato Kusunoki
Afferent limb syndrome (ALS) is caused by an obstruction of the afferent intestinal limb after ileal pouch-anal anastomosis. Here, we describe the first case of ALS to be successfully treated by a laparoscopic approach. A 27-year-old man underwent ileal pouch-anal anastomosis for ulcerative colitis. He was subsequently diagnosed with ALS and underwent ileopexy with laparotomy at 33 years old. Then, 21 months after the first ileopexy, he underwent laparoscopic ileopexy for ALS recurrence. The operative findings revealed a shortened fixed portion of the afferent limb adhering to the right pelvic retroperitoneum, which was regarded as the cause of the acute angulation...
June 30, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28662525/colonic-histological-criteria-predict-development-of-pouchitis-after-ileal-pouch-anal-anastomosis-for-patients-with-ulcerative-colitis
#18
Toshimitsu Araki, Kiyoshi Hashimoto, Yoshiki Okita, Hiroyuki Fujikawa, Satoru Kondo, Minako Kobayashi, Masaki Ohi, Yuji Toiyama, Yasuhiro Inoue, Keiichi Uchida, Yasuhiko Mohri, Masato Kusunoki
BACKGROUND/AIMS: Pouchitis is one of the main complications after ileal pouch-anal anastomosis in patients with ulcerative colitis. The aim of this study was to determine whether the use of colonic histological criteria can predict the development of pouchitis. METHODOLOGY: We retrospectively reviewed 147 patients' clinical data and performed a histological evaluation of the resected total colon using Tanaka's criteria, which comprise the following 6 factors: ulceration (H1), crypt abscesses (H2), degree of mononuclear cell infiltration (MNCI) (H3), segmental distribution of MNCI (H4), eosinophil infiltration (H5), and extent of disease of resected colon (H6)...
June 30, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28649762/the-usefulness-of-the-h-pouch-configuration-in-salvage-surgery-for-failed-ileal-pouches
#19
H Hande Aydinli, Colin Peirce, Erman Aytac, Feza Remzi
AIM: Abdominal salvage surgery for a failed ileal pouch-anal anastomosis (IPAA) is safe and feasible in experienced hands. When salvaging an ileal pouch or creating a new J, S or W-pouch may not be feasible, construction of an H-pouch may be the final option. This study reports a single colorectal surgeon's experience on H-pouch anal anastomosis in patients referred with a failed ileal pouch. METHOD: Patients undergoing transabdominal salvage surgery with H-pouch formation for a failed pouch from February 2012 to May 2016 were evaluated...
June 26, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28633443/nod2-genetic-variants-predispose-one-of-two-familial-adenomatous-polyposis-siblings-to-pouchitis-through-microbiome-dysbiosis
#20
Kathleen M Schieffer, Justin R Wright, Leonard R Harris, Sue Deiling, Zhaohai Yang, Regina Lamendella, Gregory S Yochum, Walter A Koltun
Background and Aims: Individuals with familial adenomatous polyposis (FAP) may undergo a total proctocolectomy with ileal pouch-anal anastomosis (IPAA) to surgically treat their disease. Inflammation of the ileal pouch, termed pouchitis, is uncommon in FAP patients but prevalent in patients who received IPAA for ulcerative colitis, a type of inflammatory bowel disease (IBD). Methods and Results: We report on two FAP siblings, living in the same household, who underwent IPAA surgery within one week of each other...
June 19, 2017: Journal of Crohn's & Colitis
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