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Ileal pouch

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https://www.readbyqxmd.com/read/29147895/routine-virtual-ileostomy-following-restorative-proctocolectomy-for-familial-adenomatous-polyposis
#1
Peter C Ambe, Hubert Zirngibl, Gabriela Möslein
BACKGROUND: Anastomotic leakage (AL) is the most feared complication in colorectal surgery. A diverting ileostomy is routinely used to prevent or reduce morbidity and mortality following AL. However, a diverting ileostomy cannot prevent AL. Besides, diverting ileostomy might be associated with relevant complications. Herein, we introduce the virtual ileostomy as an alternative to diverting ileostomy in patients undergoing restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) for familial adenomatous polyposis (FAP)...
November 16, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29135694/impact-of-prostate-cancer-and-its-treatment-on-the-outcomes-of-ileal-pouch-anal-anastomosis
#2
Lei Lian, Jean Ashburn, Erick M Remer, Feza H Remzi, Manoj Monga, Bo Shen
BACKGROUND: There are scant published data in the impact of prostate cancer and its treatment on functional outcomes and quality of life (QOL) in patients with ileal pouch-anal anastomosis (IPAA). The aim of the study was to evaluate the influence of prostate cancer and its treatment on functional outcomes and QOL in patients with IPAA. METHODS: Patients with IPAA with prostate cancer were compared to age and pouch duration-matched controls without prostate cancer in a 1:2 ratio...
December 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29126508/complications-in-children-with-ulcerative-colitis-undergoing-ileal-pouch-anal-anastomosis
#3
Dani O Gonzalez, Benedict C Nwomeh
Total colectomy with ileal pouch-anal anastomosis (IPAA) is considered the standard procedure for the surgical management of ulcerative colitis. Despite the widespread utility of the procedure, as many as 75% of patients who undergo IPAA, experience at least 1 complication. This review highlights difficult intraoperative scenarios and complications of pouch surgery in children, including intraoperative, postoperative, and functional complications. Intraoperative scenarios include insufficient mesenteric length and positive leak tests...
December 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29125801/laparoscopic-versus-open-restorative-proctocolectomy-for-familial-adenomatous-polyposis
#4
Fábio Guilherme Campos, Carlos Augusto Real Martinez, Mariane Gouveia Monteiro de Camargo, Daniele Menezes Cesconetto, Sérgio Carlos Nahas, Ivan Cecconello
PURPOSE: This study compared outcomes after laparoscopic (LAP) or conventional (open) total proctocolectomy with outcomes after ileal J-pouch anal anastomosis (IPAA) at a single institution. METHODS: Charts from 133 familial adenomatous polyposis patients (1997-2013) were reviewed. Demographic data (age, sex, color, American Society of Anesthesiologists [ASA] status, previous surgery, and body mass index) and surgical outcomes (length of stay, early and late morbidity, reoperation, and mortality rates) were compared among 63 patients undergoing IPAA...
November 10, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29112570/rectal-eversion-technique-a-method-to-achieve-very-low-rectal-transection-and-anastomosis-with-particular-value-in-laparoscopic-cases
#5
Vitaliy Poylin, Peter Mowschenson, Deborah Nagle, Thomas Cataldo
INTRODUCTION: Transection of the rectum at the anorectal junction is required for proper resection in ulcerative colitis and restorative proctocolectomy. Achieving stapled transection at the pelvic floor is often challenging, particularly during laparoscopic proctectomy. Transanal mucosectomy and handsewn anastomosis are frequently used to achieve adequate resection. Rectal eversion provides an alternative for low anorectal transection and maintains the ability to perform stapled anastomosis...
December 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29108960/perioperative-morbidity-bowel-function-and-oncologic-outcome-after-radical-cystectomy-and-ileal-orthotopic-neobladder-reconstruction-studer-pouch-versus-i-pouch
#6
Johannes Mischinger, Mohamed F Abdelhafez, Steffen Rausch, Tilman Todenhöfer, Eva Neumann, Stefan Aufderklamm, Arnulf Stenzl, Georgios Gakis
OBJECTIVE: To investigate whether the length of ileum used for ileal orthotopic neobladder (ONB) reconstruction (60 cm vs. 40 cm) after radical cystectomy (RC) for bladder cancer (BC) impacts on bowel function, postoperative complications or survival outcome. MATERIAL AND METHODS: In this retrospective study, we included 56 patients who received an ONB (Studer (S)-Pouch: 23 patients; I-Pouch: 33 patients) after RC for BC between 2003 and 2011. Preoperative comorbidities were assessed by the Charlson Comorbidity Index (CCI) and surgical complications as graded by the Clavien-Dindo classification...
October 20, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29104126/long-term-quality-of-life-associated-with-early-surgical-complications-in-patients-with-ulcerative-colitis-after-ileal-pouch-anal-anastomosis-a-single-center-retrospective-study
#7
Weimin Xu, Hairong Ye, Yilian Zhu, Wenjun Ding, Jihong Fu, Long Cui, Peng Du
BACKGROUND: Ileal pouch-anal anastomosis (IPAA) is recommended for patients with ulcerative colitis (UC) in terms of surgical treatment. Measuring surgical complications of IPAA and long-term quality of life (QOL) are important to achieve an acceptable risk/benefit ratio for patients with UC. MATERIALS AND METHODS: Patients with UC who underwent total proctocolectomy (TPC) with IPAA from February 2008 to July 2016 at our institute were included. Early surgical complications were defined as mechanical/infectious events within one month after IPAA...
November 7, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29099467/genotype-phenotype-associations-of-apc-mutations-with-pouch-adenoma-in-patients-with-familial-adenomatous-polyposis
#8
Revital Kariv, Guy Rosner, Naomi Fliss-Isakov, Nathan Gluck, Adam Goldstein, Hagit Tulchinsky, Shira Zelber-Sagi
BACKGROUND: Patients with familial adenomatous polyposis (FAP) may carry various adenomatous polyposis coli (APC) mutations. However, genotype-phenotype correlation for APC mutations is still debated and is yet to be evaluated with regard to pouch polyp formation. OBJECTIVE: To evaluate the association between APC mutation type and exon location and the outcome of pouch adenoma. DESIGN SETTING AND PATIENTS: Forty-five FAP patients with defined pathogenic APC mutations, who underwent total proctocolectomy and ileal pouch anal anastomosis were classified by mutation type and location...
November 3, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29091335/outcome-of-restorative-proctocolectomy-with-ileo-anal-pouch-for-ulcerative-colitis-effect-of-changes-in-clinical-practice
#9
Adeline Germain, Anthony de Buck van Overstraeten, Albert Wolthuis, Marc Ferrante, Séverine Vermeire, Gert Van Assche, Andre D'Hoore
BACKGROUND: Surgery for ileal pouch-anal anastomosis (IPAA) has evolved over time, especially since the introduction of laparoscopy. OBJECTIVE: The aim of this retrospective study was to report the impact of surgical evolution on outcome over a period of 25 years. DESIGN AND PATIENTS: All patients with IPAA surgery for ulcerative colitis from 1990 to 2015 at the University Hospitals of Leuven were included. Patients were divided into 3 period arms (Period A:1990 - 1999; Period B: 2000 - 2009; Period C: 2010 - 2015)...
November 1, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29049337/factors-affecting-pouch-related-outcomes-after-restorative-proctocolectomy
#10
Gyoung Tae Noh, Jeonghee Han, Min Soo Cho, Hyuk Hur, Byung Soh Min, Kang Young Lee, Nam Kyu Kim
PURPOSES: Restorative proctocolectomy (RPC) with ileal pouch anal anastomosis (IPAA) is the procedure of choice for patients with familial adenomatous polyposis (FAP) and ulcerative colitis (UC) despite morbidities that can lead to pouch failure. We aimed to identify factors associated with pouch-related morbidities. METHODS: A retrospective analysis of patients who underwent RPC with IPAA was performed. To investigate the factors associated with pouch-related morbidities, patients' preoperative demographic and clinical factors, and intraoperative factors were included in the analysis...
2017: PloS One
https://www.readbyqxmd.com/read/29043868/determinants-of-optimal-bowel-function-in-ileal-pouch-anal-anastomosis-physiological-differences-contributing-to-pouch-function
#11
Marie Louise Sunde, Petr Ricanek, Tom Øresland, Jørgen Jahnsen, Nazir Naimy, Arne Engebreth Færden
BACKGROUND: Variability in functional outcome after ileal-pouch anal anastomosis (IPAA) is to a large extent unexplained. The aim of this study was to perform multiple physiological and biochemical tests including an endoscopic examination with histology on IPAA patients with well and poorly functioning pouches to determine factors, or combinations thereof, contributing to functional outcome. METHODS: All patients with ulcerative colitis undergoing restorative proctocolectomy between 2000 and 2013 (N = 108) were interviewed using a pouch functioning score...
October 18, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29033223/who-gets-a-pouch-after-colectomy-in-new-york-state-and-why
#12
Christopher T Aquina, Fergal J Fleming, Adan Z Becerra, Bradley J Hensley, Katia Noyes, John R T Monson, Larissa K Temple, Christina Cellini
BACKGROUND: This study identified variation and factors associated with ileal pouch-anal anastomosis after total colectomy for ulcerative colitis. METHODS: The Statewide Planning & Research Cooperative System was used to identify patients with ulcerative colitis who underwent total colectomy in New York state from 2000-2013. Bivariate and mixed-effects multivariable analyses were performed to assess patient, surgeon, and hospital-level factors as well as surgeon and hospital-level variation associated with ileal pouch-anal anastomosis after total colectomy...
October 12, 2017: Surgery
https://www.readbyqxmd.com/read/28985852/development-of-a-total-colectomy-and-ileorectal-anastomosis-rat-model-to-evaluate-colonic-metaplasia
#13
Kathleen M Schieffer, Lisa S Poritz, Gregory S Yochum, Walter A Koltun
BACKGROUND: Ulcerative colitis is an idiopathic inflammatory condition of the colon that may require surgical intervention including proctocolectomy and either ileal pouch-anal anastomosis or in the pediatric population, low ileorectal anastomosis (IRA). Often, subsequent physiologic alteration (or colonic metaplasia) occurs in the anastomosed small bowel that includes changes in mucin content, villous blunting, and increased expression of WNT5A, a marker of colonic crypt regeneration...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28981638/long-term-risk-of-cancer-following-ileal-pouch-anal-anastomosis-for-ulcerative-colitis
#14
Anders Mark-Christensen, Rune Erichsen, Søren Brandsborg, Jacob Rosenberg, Niels Qvist, Ole Thorlacius-Ussing, Jens Hillingsø, Jørn Helmut Pachler, Erica Gould Christiansen, Søren Laurberg
Background: The overall risk of cancer following ileal pouch-anal anastomosis [IPAA] is unknown, and pouch cancer surveillance is controversial. We evaluated long-term risk of cancer in a national cohort of patients with ulcerative colitis and IPAA, with emphasis on pouch cancer. Methods: Data on incident cancers were extracted from the national Danish Cancer Registry. Incidence rates for all site-specific cancers were compared between patients with IPAA and a gender- and age-matched comparison cohort from the background population to obtain incidence rate ratios [IRRs]...
August 3, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/28940230/outcome-after-restorative-proctocolectomy-and-ileal-pouch-anal-anastomosis-in-children-and-adults
#15
COMPARATIVE STUDY
K Diederen, S S Sahami, M M Tabbers, M A Benninga, A Kindermann, P J Tanis, M W Oomen, J R de Jong, W A Bemelman
BACKGROUND: Studies comparing the outcome of ileal pouch-anal anastomosis (IPAA) in children and adults are scarce. This complicates decision-making in young patients. The aim of this study was to compare adverse events and pouch function between children and adults who underwent IPAA. METHODS: This cross-sectional cohort study included all consecutive children (aged less than 18 years) and adults with a diagnosis of inflammatory bowel disease or familial adenomatous polyposis who underwent IPAA in a tertiary referral centre between 2000 and 2015...
November 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28929216/refractory-pouchitis-improves-after-administration-of-the-green-tea-polyphenol-egcg-a-retrospective-review
#16
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
#17
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...
December 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28911880/pelvic-exenteration-for-gynecologic-malignancies-postoperative-complications-and-oncologic-outcomes
#18
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
#19
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
#20
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
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