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https://www.readbyqxmd.com/read/29126508/complications-in-children-with-ulcerative-colitis-undergoing-ileal-pouch-anal-anastomosis
#1
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/29106505/successful-treatment-with-vedolizumab-in-a-patient-with-chronic-refractory-pouchitis-and-primary-sclerosing-cholangitis
#2
M Coletta, M Paroni, F Caprioli
No abstract text is available yet for this article.
July 5, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/29067882/alicaforsen-in-the-treatment-of-pouchitis
#3
Thomas Greuter, Gerhard Rogler
Alicaforsen is a 20-base antisense oligonucleotide inhibiting ICAM-1 production, which is an important adhesion molecule involved in leukocyte migration and trafficking to the site of inflammation. Hitherto, alicaforsen has been granted orphan drug designation and is prescribed as an unlicensed medicine in accordance with international regulation for the treatment of pouchitis and left-sided ulcerative colitis. Given the positive results evolving from one open-label trial and one case series in patients with chronic refractory pouchitis, US FDA has agreed to a rolling submission for a license application for the treatment of pouchitis, which has been recently initiated...
November 2017: Immunotherapy
https://www.readbyqxmd.com/read/29049337/factors-affecting-pouch-related-outcomes-after-restorative-proctocolectomy
#4
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
#5
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/28982899/transanal-assisted-resection-with-closure-of-anal-canal-for-lower-rectal-diseases
#6
Hidejiro Kawahara, Tadashi Akiba, Katsuhiko Yanaga
BACKGROUND/AIM: Abdominoperineal resection (APR) has been performed for lower rectal cancer, anal cancer and inflammatory diseases, but is associated with postoperative complications such as inflammation of pelvic dead space or perineal wound infection. We are performing a novel procedure (transanal assisted resection with closure of anal canal, TARC) that resects the intestine by using transanal assist and close the anal canal for patients who do not require resection of the anus and anal canal...
October 2017: Anticancer Research
https://www.readbyqxmd.com/read/28940230/outcome-after-restorative-proctocolectomy-and-ileal-pouch-anal-anastomosis-in-children-and-adults
#7
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
#8
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
#9
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/28852524/fecal-microbiota-transplantation-for-clostridium-difficile-infection-in-patients-with-ileal-pouches
#10
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/28804459/metabolic-variability-of-a-multispecies-probiotic-preparation-impacts-on-the-anti-inflammatory-activity
#11
Michele Biagioli, Luca Laghi, Adriana Carino, Sabrina Cipriani, Eleonora Distrutti, Silvia Marchianò, Carola Parolin, Paolo Scarpelli, Beatrice Vitali, Stefano Fiorucci
Background: In addition to strain taxonomy, the ability of probiotics to confer beneficial effects on the host rely on a number of additional factors including epigenetic modulation of bacterial genes leading to metabolic variability and might impact on probiotic functionality. Aims: To investigate metabolism and functionality of two different batches of a probiotic blend commercialized under the same name in Europe in models of intestinal inflammation. Methods: Boxes of VSL#3, a probiotic mixture used in the treatment of pouchitis, were obtained from pharmacies in UK subjected to metabolomic analysis and their functionality tested in mice rendered colitis by treatment with DSS or TNBS...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28765694/lactobacillus-acidophilus-alleviates-pouchitis-after-ileal-pouch-anal-anastomosis-in-rats
#12
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/28737964/laparoscopic-duhamel-procedure-with-ex-anal-rectal-transection-for-right-sided-hirschsprung-s-disease
#13
Xi Zhang, Li Yang, Shao-Tao Tang, Guo-Qing Cao, Shuai Li, Meng Jiang, Meng Xiong, De-Hua Yang, Xiao-Pan Chang, Kang Li, Ya-Zhen Ma
BACKGROUND: Increased defecation frequency and soiling are common complications of surgery for right-sided Hirschsprung's disease (HD). Though the laparoscopic Duhamel procedure is a favorable option in right-sided HD, the conventional laparoscopic technique is time consuming and has complications that are associated with the reservoir. In this study, we described a modified laparoscopic Duhamel technique with ex-anal rectal transection combined with the Deloyer's procedure for right-sided HD...
September 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28705638/laparoscopic-assisted-duhamel-procedure-with-ex-anal-rectal-transection-for-total-colonic-aganglionosis
#14
Xi Zhang, Guo-Qing Cao, Shao-Tao Tang, Xiao-Pan Chang, Shuai Li, Li Yang, Kang Li, Ying Zhou, De-Hua Yang
PURPOSE: Laparoscopic-assisted Duhamel procedure has a larger anastomosis and a reservoir which allows early recovery of defecation frequency, but concerns have been raised regarding the long operative time, high incidence of pouchitis and Hirschsprung associated enterocolitis (HAEC). The purpose of this study was to evaluate the postoperative complications and functional outcomes for patients with TCA undergoing modified laparoscopic-assisted Duhamel procedure (MLDP) with ex-abdominal partial colectomy and ex-anal rectal transection...
June 27, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28670932/alicaforsen-for-the-treatment-of-inflammatory-bowel-disease
#15
REVIEW
Vipul Jairath, Reena Khanna, Brian G Feagan
Intracellular adhesion molecule-1 (ICAM-1), is a transmembrane glycoprotein of the immunoglobulin family, constitutively expressed on vascular endothelial cells and upregulated in inflamed colonic tissue. Alicaforsen, a 20 base ICAM-1 anti-sense oligonucleotide and highly selective ICAM-1 inhibitor, down-regulates ICAM-1 mRNA. Areas covered: We review mechanism of action, pharmacokinetics, pre-clinical, clinical and safety data of alicaforsen for the treatment of ulcerative colitis (UC), pouchitis and Crohn's disease (CD)...
August 2017: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/28664992/the-outcome-of-ulcerative-colitis-patients-undergoing-pouch-surgery-is-determined-by-pre-surgical-factors
#16
H Yanai, S Ben-Shachar, L Mlynarsky, L Godny, M Leshno, H Tulchinsky, I Dotan
BACKGROUND: Pouch surgery, a common intervention for ulcerative colitis (UC) complications, is often associated with the development of pouchitis. AIM: To identify predictors of pouch outcome in a cohort of patients with UC. METHODS: We conducted a retrospective unmatched case-cohort study in a tertiary IBD referral centre. Adult patients with UC were classified into the worst phenotype throughout follow-up: normal pouch, a form of chronic pouchitis (either chronic pouchitis or Crohn's like disease of pouch [CLDP]), or episodic recurrent acute pouchitis (RAP)...
September 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28662525/colonic-histological-criteria-predict-development-of-pouchitis-after-ileal-pouch-anal-anastomosis-for-patients-with-ulcerative-colitis
#17
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/28633443/nod2-genetic-variants-predispose-one-of-two-familial-adenomatous-polyposis-siblings-to-pouchitis-through-microbiome-dysbiosis
#18
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...
October 27, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/28600635/altered-expression-of-micrornas-in-patients-with-pouchitis-after-restorative-proctocolectomy
#19
Emi Inoue, Keisuke Hata, Hideaki Kimura, Kiyoshi Yamaguchi, Masanori Nojima, Itaru Endo, Masaru Shinozaki
BACKGROUND AND PURPOSE: Pouchitis is the most common long-term complication of restorative proctocolectomy with ileal pouch-anal anastomosis. We investigated alterations in the expression of microRNAs, noncoding RNAs that act as potent negative regulators of gene expression, in pouchitis. METHODS: The subjects of this study were 16 patients with diagnosed pouchitis and 48 patients without pouchitis after restorative proctocolectomy, performed for ulcerative colitis...
December 2017: Surgery Today
https://www.readbyqxmd.com/read/28595172/routine-pouchoscopy-prior-to-ileostomy-takedown-may-not-be-necessary-in-patients-with-chronic-ulcerative-colitis
#20
Jennifer X Cai, Jasmine Barrow, Alyssa Parian, Steven R Brant, Sharon Dudley-Brown, Jonathan Efron, Sandy Fang, Susan Gearhart, Michael Marohn, Bashar Safar, Brindusa Truta, Elizabeth Wick, Mark Lazarev
BACKGROUND: Creation of a J pouch is the gold standard surgical intervention in the treatment of chronic ulcerative colitis (UC). Pouchoscopy prior to ileostomy takedown is commonly performed. We describe the frequency, indication, and findings on pouchoscopy, and determine if pouchoscopy affects rates of complications after takedown. METHODS: All UC or indeterminate inflammatory bowel disease patients with a J pouch were retrospectively evaluated from January 1994 to December 2014...
2018: Digestive Diseases
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