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Ileoanal pouch

Guy H T Worley, Nicola S Fearnhead, Steven R Brown, Austin G Acheson, Matthew J Lee, Omar D Faiz
INTRODUCTION: The second ACPGBI Ileoanal Pouch Registry (IPR) report was released in July 2017 following a first report in 2012. This article provides a summary of data derived from the most recent IPR report (1). METHOD: The IPR is an electronic database of voluntarily submitted data including patient demographics, disease, intra and post-operative factors submitted by consultant surgeons or delegates. Data up to 31st March 2017 have been analysed for this report...
June 21, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
G H T Worley, J P Segal, J Warusavitarne, S K Clark, O D Faiz
AIM: It is well established that ileo-anal pouch-related septic complications (PRSC) increase the risk of pouch failure. There are a number of publications that describe the management of early PRSC in ulcerative colitis (UC) in small series. This article aims to systematically review and summarize the relevant current data on this subject and provide an algorithm for the management of early PRSC. METHOD: A systematic review was undertaken in accordance with PRISMA guidelines...
May 16, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Mathurin Fumery, Niraj S Patel, Brigid S Boland, Parambir S Dulai, Siddharth Singh, William J Sandborn
Background and aims: Colectomy with ileoanal pouch is the standard of care for most patients with ulcerative colitis (UC) who require surgery. However, 5%-38% of patients with ileoanal pouch develop pouch strictures that can severely impact the functional results. We retrospectively evaluated the efficacy and safety of endoscopic balloon dilation of ileoanal pouch strictures in patients with inflammatory bowel disease (IBD). Methods: All consecutive patients with IBD that underwent endoscopic balloon dilatation of a pouch stricture at our institution between January 1, 2011, and April 31, 2016, were included...
May 18, 2018: Inflammatory Bowel Diseases
C Simillis, T Afxentiou, G Pellino, C Kontovounisios, S Rasheed, O Faiz, P P Tekkis
AIM: There is no consensus as to which ileoanal pouch design provides better outcomes after restorative proctocolectomy. This study compares different pouch designs. METHOD: A systematic review of the literature was performed. A random effects meta-analytical model was used to compare adverse events and functional outcome. RESULTS: Thirty comparative studies comparing J, W, S and K pouch designs were included. No significant differences were identified between the different pouch designs with regard to anastomotic dehiscence, anastomotic stricture, pelvic sepsis, wound infection, pouch fistula, pouch ischaemia, perioperative haemorrhage, small bowel obstruction, pouchitis and sexual dysfunction...
March 25, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Jonathan P Segal, Heyson Chan, Brigitte Collins, Omar D Faiz, Susan K Clark, Ailsa L Hart
OBJECTIVES: To report outcomes following biofeedback for functional problems associated with an ileoanal pouch. Incontinence and evacuatory disorders associated with the ileoanal pouch can be particularly problematic and difficult to treat using conventional therapies. Biofeedback therapy is a behavioural treatment that offers a non-surgical approach as an alternative or adjunct for patients. MATERIALS AND METHODS: This was a retrospective single centre study. We reviewed the notes of all patients attending for biofeedback at our institution between January 2012 and October 2017 and identified all those that did so for ileoanal pouch related problems...
June 2018: Scandinavian Journal of Gastroenterology
Amin Makni, Houcine Magherbi, Yassine Ben Safta, Amine Sebai, Sofiene Ayadi, Zoubeir Ben Safta
No abstract text is available yet for this article.
March 2017: La Tunisie Médicale
Dejan Micic, Andres Yarur, Alex Gonsalves, Vijaya L Rao, Susan Broadaway, Russell Cohen, Sushila Dalal, John N Gaetano, Laura R Glick, Ayal Hirsch, Joel Pekow, Atsushi Sakuraba, Seth T Walk, David T Rubin
INTRODUCTION: Clostridium difficile is the most commonly isolated stool pathogen in inflammatory bowel disease (IBD). Traditional risk factors for C. difficile may not exist in patients with IBD, and no prior studies have assessed the risk factors for the isolation of C. difficile in both symptomatic and asymptomatic IBD outpatients. METHODS: We prospectively recruited consecutive IBD patients presenting to our outpatient clinic between April 2015 and February 2016...
April 2018: Digestive Diseases and Sciences
N S Fearnhead, M J Lee, A G Acheson, G Worley, O D Faiz, S R Brown
AIM: Increasing scrutiny on both individual and unit outcomes after surgical procedures is now expected. In the field of inflammatory bowel disease, this is particularly pertinent for outcomes after ileoanal pouch surgery. METHOD: The Surgical Workload and Outcomes Research Database (SWORD) relies on administrative data derived from Hospital Episode Statistics collected in England. The platform was interrogated for pouch procedures undertaken in England between April 2009 and December 2016 to assess national caseload and, between April 2012 and December 2016, to assess variation in caseload and outcomes after pouch surgery...
July 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Aoibhlinn O'Toole, Punyanganie S de Silva, Linda G Marc, Christine A Ulysse, Marcia A Testa, Amanda Ting, Alan Moss, Josh Korzenik, Sonia Friedman
Background: Men with inflammatory bowel disease (IBD) may have increased sexual dysfunction. To measure the prevalence of sexual dysfunction in our male patients, we aimed to develop a new IBD-specific Male Sexual Dysfunction Scale (the IBD-MSDS). Methods: We used a cross-sectional survey and enrolled male patients (N = 175) ≥18 years old who attended IBD clinics at 2 Boston hospitals. We collected information on sexual functioning via a 15-item scale. General male sexual functioning was measured using the International Index of Erectile Dysfunction (IIEF); the Patient Health Questionnaire (PHQ-9) measured depressive symptoms...
January 18, 2018: Inflammatory Bowel Diseases
Alexander T Hawkins, Jun W Um, Amosy E M'Koma
Restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis (IPAA) is the standard surgical treatment for ulcerative colitis (UC). Emergency colectomies are performed for fulminant colitis (ie, toxic megacolon, profuse bleeding, perforation, or sepsis). The RPC and IPAA involve manipulation of the proximal ileum, which may influence the essential physiological function of gut-associated lymphoid tissues. Circulating plasma immunoglobulin G (p-IgG) deficiency is observed in patients with fulminant UC...
2017: Clinical Medicine Insights. Gastroenterology
J P Segal, S Oke, G L Hold, S K Clark, O D Faiz, A L Hart
BACKGROUND: The resident gut microbiota is essential for physiological processes; the disturbance of its balance is linked to intestinal inflammation. The ileoanal pouch is a model for the study of intestinal inflammation, as inflammation of the pouch is common and mostly develops within 12 months following ileostomy closure. This allows the longitudinal study of the microbiota, giving insight into the microbiota changes during transition from a normal to an inflamed pouch. AIM: To explore the literature on the microbiota of the ileoanal pouch in health and disease...
February 2018: Alimentary Pharmacology & Therapeutics
Rajan Chaudhry
Sixteen patients of ulcerative colitis and two of familial adenomatous polyposis were subjected to anorectal manometry, a minimal of three months after Pouch Ileo-Anal Anastomosis and closure of ileostomy. Using a perfusion catheter the parameters measured were resting anal pressure (RAP), maximum squeeze pressure (MSP), pouch volume and compliance at maximum tolerated volume. Subjective evaluation included anal continence and frequency of stools. The subjective functional results after surgery were then correlated with the objective findings of manometry...
April 1998: Medical Journal, Armed Forces India
B Jansen-Winkeln, O Lyros, A Lachky, N Teich, I Gockel
Restorative proctocolectomy with an ileoanal pouch anastomosis (IAPA) is the surgical therapy of choice for patients with refractory ulcerative colitis and/or associated (pre)neoplastic lesions. It is predominantly performed laparoscopically. Reconstruction with a J‑pouch is the most frequently applied variant due to the ideal combination of technical simplicity and good long-term results. In the present review, potential postoperative pouch complications, their risk factors, diagnostics and surgical management, as well as mid-term and long-term quality of life after pouch construction are differentially presented based on the current literature...
December 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Marin J de Jong, Andrea E van der Meulen-de Jong, Mariëlle J Romberg-Camps, Marco C Becx, Jeroen P Maljaars, Mia Cilissen, Ad A van Bodegraven, Nofel Mahmmod, Tineke Markus, Wim M Hameeteman, Gerard Dijkstra, Ad A Masclee, Annelies Boonen, Bjorn Winkens, Astrid van Tubergen, Daisy M Jonkers, Marie J Pierik
BACKGROUND: Tight and personalised control of inflammatory bowel disease in a traditional setting is challenging because of the disease complexity, high pressure on outpatient clinics, and rising incidence. We compared the effects of self-management with a telemedicine system, which was developed for all subtypes of inflammatory bowel disease, on health-care utilisation and patient-reported quality of care versus standard care. METHODS: We did this pragmatic, randomised trial in two academic and two non-academic hospitals in the Netherlands...
September 2, 2017: Lancet
C T Germer, A J Kroesen
No abstract text is available yet for this article.
July 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
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
A J Kroesen
Restorative proctocolectomy under formation of an ileoanal/ileorectal J‑pouch has become the procedure of choice in the therapy of ulcerative colitis. Although patients experience a dramatic improvement of their quality of life, surgery is not successful in about 5-10% of all treated patients. The reasons for failure are chronic pouchitis, incontinence, delayed diagnosis of Crohn's disease, fistula, surgical complications, too long remnant rectal stump, chronic abscess, and surgical technical errors. Some of the reasons do not always prevent the loss of a well-functioning ileoanal pouch...
July 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Jacqueline Sammut, Rita Borg Xuereb, Josianne Scerri
The purpose of this study was to explore the lived experiences of individuals living with an ileoanal pouch. A qualitative, phenomenological methodology was used to elicit detailed accounts of the impact of living with an ileoanal pouch. Ten individuals having an ileoanal pouch, formed as a consequence of ulcerative colitis, participated in the study. Semistructured interviews were conducted and analyzed using interpretative phenomenological analysis. The following 4 themes emerged from the analysis: "a flood of emotions"; "changed body image"; "changes in lifestyle"; and "intimacy and sexual relationships...
September 2017: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
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...
July 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
A L Lightner, S Dattani, E J Dozois, S B Moncrief, J H Pemberton, K L Mathis
AIM: Restorative proctocolectomy with ileal-pouch anal anastomosis 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...
October 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
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