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Ulcerative colitis surgery

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https://www.readbyqxmd.com/read/28633443/nod2-genetic-variants-predispose-one-of-two-familial-adenomatous-polyposis-siblings-to-pouchitis-through-microbiome-dysbiosis
#1
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
https://www.readbyqxmd.com/read/28630047/update-on-anti-tumor-necrosis-factor-agents-and-other-new-drugs-for-inflammatory-bowel-disease
#2
REVIEW
Benjamin L Cohen, David B Sachar
The treatment of inflammatory bowel disease (IBD)-ulcerative colitis (UC) and Crohn's disease (CD)-has evolved beyond surgery with the introduction of biologic agents, primarily antibodies against mediators of inflammation and cell attraction. Anti-tumor necrosis factor (TNF) agents have been the first line treatment for moderate to severe ulcerative colitis and Crohn's disease for more than 15 years. During that time much has been learnt about how best to use these agents. This review will assess the evidence on how to optimize the use of anti-TNF agents; when and how to start treatment; how to monitor treatment and when to de-escalate it; and the potential adverse effects of these drugs...
June 19, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28626380/clinical-and-pathologic-remission-of-pediatric-ulcerative-colitis-with-serum-derived-bovine-immunoglobulin-added-to-the-standard-treatment-regimen
#3
Rachelle A Soriano, Asuncion G Ramos-Soriano
Ulcerative colitis (UC) is a chronic inflammatory bowel disease that is particularly troublesome for pediatric patients, as current therapeutic options consist of biologic agents and steroids which alter the immune response and have the harmful side effect of leaving the patient more susceptible to opportunistic infections and eventual surgery. Another option for therapy exists in the form of serum-derived bovine immunoglobulin/protein isolate (SBI), the key ingredient in a medical food, EnteraGam®. The FDA has reviewed the safety of SBI and issued a no challenge letter to the generally recognized as safe (GRAS) findings for this medical food...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28614561/association-of-preoperative-anti-tumor-necrosis-factor-therapy-with-adverse-postoperative-outcomes-in-patients-undergoing-abdominal-surgery-for-ulcerative-colitis
#4
Audrey S Kulaylat, Afif N Kulaylat, Eric W Schaefer, Andrew Tinsley, Emmanuelle Williams, Walter Koltun, Christopher S Hollenbeak, Evangelos Messaris
Importance: Despite the increasing use of anti-tumor necrosis factor (TNF) therapy in ulcerative colitis, its effects on postoperative outcomes remain unclear, with many patients requiring surgical intervention despite optimal medical management. Objective: To assess the association of preoperative use of anti-TNF agents with adverse postoperative outcomes. Design, Setting, and Participants: This analysis used insurance claims data from a large national database to identify patients 18 years or older with ulcerative colitis...
June 14, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28607285/rationalisation-of-the-surgical-technique-for-minimally-invasive-laparoscopic-ileal-pouch-anal-anastomosis-after-previous-total-colectomy-for-ulcerative-colitis
#5
Francesco Giudici, Stefano Scaringi, Carmela Di Martino, Ferdinando Ficari, Paolo Bechi
INTRODUCTION: No previous study clearly focuses on laparoscopic technique to perform the second stage surgery (proctectomy with ileal pouch-anal anastomosis [IPAA]) after total colectomy for acute/severe ulcerative colitis (UC). We describe the procedural steps for a simple and rational minimally invasive second stage surgery, reporting intra- and short-term post-operative results. PATIENTS AND METHODS: During the period December 2014-December 2015, 10 consecutive patients (8 males and 2 females) with mean age of 48 years underwent laparoscopic proctectomy and IPAA adopting our novel approach...
July 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28606755/recommendations-of-the-spanish-working-group-on-crohn-s-disease-and-ulcerative-colitis-geteccu-on-the-monitoring-prevention-and-treatment-of-post-operative-recurrence-in-crohn-s-disease
#6
Eugeni Domènech, Antonio López-Sanromán, Pilar Nos, Maribel Vera, María Chaparro, María Esteve, Javier P Gisbert, Míriam Mañosa
Despite the availability of new, powerful drugs for Crohn's disease, a significant proportion of patients will undergo an intestinal resection to control the disease as it develops. In the absence of an effective preventative treatment, the appearance of new intestinal lesions after surgery for Crohn's disease is the norm; this is known as post-operative recurrence and may appear very early on, even a few weeks after the surgical resection. Furthermore, the drugs that are currently available for the prevention of post-operative recurrence have a limited effect; up to 50% of cases present recurrent Crohn's disease activity despite the preventative treatment, which may require further surgery with the consequent loss of intestinal function, leading some patients to suffer from short bowel syndrome as an irreversible complication...
June 9, 2017: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/28603049/ethnicity-influences-phenotype-and-outcomes-in-inflammatory-bowel-disease-a-systematic-review-and-meta-analysis-of-population-based-studies
#7
Haiyun Shi, Alexander N Levy, Hirsh D Trivedi, Francis Kl Chan, Siew C Ng, Ashwin N Ananthakrishnan
INTRODUCTION: Inflammatory bowel diseases (IBD; Crohn's disease (CD), ulcerative colitis (UC)) are global diseases. Similarities and differences in disease presentation and outcomes across different geographic regions and ethnic groups have not been compared previously. METHODS: We performed a systematic review and meta-analysis of population based cohort studies examining the phenotype and outcome of IBD across ethnic groups, categorized as Whites, Blacks, Hispanics and Asians...
June 8, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28595172/routine-pouchoscopy-prior-to-ileostomy-takedown-may-not-be-necessary-in-patients-with-chronic-ulcerative-colitis
#8
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...
June 9, 2017: Digestive Diseases
https://www.readbyqxmd.com/read/28594721/analysis-of-postoperative-venous-thromboembolism-in-patients-with-chronic-ulcerative-colitis-is-it-the-disease-or-the-operation
#9
Nicholas P McKenna, Kevin T Behm, Daniel S Ubl, Amy E Glasgow, Kellie L Mathis, John H Pemberton, Elizabeth B Habermann, Robert R Cima
BACKGROUND: Patients with IBD have a higher baseline risk of venous thromboembolism, which further increases with surgery. Therefore, extended venous thromboembolism chemoprophylaxis has been suggested in certain high-risk cohorts. OBJECTIVE: The purpose of this study was to determine whether the underlying diagnosis, operative procedure, or both influence the incidence of postoperative venous thromboembolism. DESIGN: This was a retrospective review...
July 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28593437/incidence-and-clinical-outcomes-of-inflammatory-bowel-disease-in-south-korea-2011-2014-a-nationwide-population-based-study
#10
Yoon Suk Jung, Minkyung Han, Won Ho Kim, Sohee Park, Jae Hee Cheon
BACKGROUND: The incidence of inflammatory bowel disease (IBD) is increasing in East Asia; however, population-based data from this region are lacking. AIM: We conducted a nationwide, population-based study to examine the incidence and disease course of IBD in South Korea. METHODS: Using the National Health Insurance claims data, we collected data on patients diagnosed with IBD [10,049 with ulcerative colitis (UC) and 5595 with Crohn's disease (CD)] from 2011 to 2014...
June 7, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28580210/immunosuppressive-medication-is-not-associated-with-surgical-site-infection-after-surgery-for-intractable-ulcerative-colitis-in-children
#11
Keiichi Uchida, Yoshikazu Ohtsuka, Atsushi Yoden, Hitoshi Tajiri, Hideaki Kimura, Takashi Isihige, Hiroyuki Yamada, Katsuhiro Arai, Takeshi Tomomasa, Kosuke Ushijima, Tomoki Aomatsu, Satoru Nagata, Kohei Otake, Kohei Matsushita, Mikihiro Inoue, Takahiro Kudo, Kenji Hosoi, Kazuo Takeuchi, Toshiaki Shimizu
Pediatric ulcerative colitis (UC) sometimes progresses to an intractable condition for medical therapy. The surgical management of UC is challenging because of difficult procedures and frequent infectious complications. The aim of this study was to survey surgical procedures and infectious complications in pediatric patients with UC in Japan and to assess the relationship between preoperatively administered immunosuppressive drugs and postoperative surgical site infection (SSI). A survey of pediatric patients treated from 2000 to 2012 was sent to 683 facilities nationwide...
May 2017: Intractable & Rare Diseases Research
https://www.readbyqxmd.com/read/28573532/-surgical-strategy-to-save-ileoanal-pouch-reconstruction
#12
REVIEW
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...
June 1, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28570245/a-descriptive-study-to-explore-the-effect-of-peristomal-skin-complications-on-quality-of-life-of-adults-with-a-permanent-ostomy
#13
Diane Maydick-Youngberg
Approximately 1 million people are living with an ostomy, and 100 000 to 130 000 new ostomies are created each year. The exact incidence and prevalence of complications are unknown but have been reported to be as high as 70% and to affect quality of life (QoL). Using convenience sampling methods, a descriptive study was conducted to explore QoL scores and peristomal complications reported by adults with a permanent ostomy attending the 2009 United Ostomy Associations of America conference. Attendees who had a permanent ileostomy, colostomy, or urostomy; were at least 18 years of age; and able to read and speak English were invited to participate...
May 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/28556347/a-case-of-ulcerative-colitis-with-squamous-cell-carcinomas-and-multiple-foci-of-squamous-dysplasia
#14
Yasuyuki Yokoyama, Ryuichi Wada, Takeshi Yamada, Eiji Uchida, Zenya Naito
Squamous cell carcinoma (SqCC) in ulcerative colitis (UC) is rare. A 38 year-old Japanese woman, who suffered from left-sided UC for 18 years, underwent total colectomy due to SqCCs in the rectum and the sigmoid colon. They were well differentiated SqCC, and metastasis was found in the paracolic lymph nodes. Multiple small foci of squamous dysplasia (SD) were noted in the rectal mucosa. Glandular dysplasia was not found. TP53 was not detected in SD. Approximately 40% of cells were immunostained with TP53 in SqCC, however no mutation was found in TP53 gene...
May 28, 2017: Pathology International
https://www.readbyqxmd.com/read/28547740/biliary-duodenal-anastomosis-using-magnetic-compression-following-massive-resection-of-small-intestine-due-to-strangulated-ileus-after-living-donor-liver-transplantation-a-case-report
#15
Ryusuke Saito, Hiroyuki Tahara, Seiichi Shimizu, Masahiro Ohira, Kentaro Ide, Kohei Ishiyama, Tsuyoshi Kobayashi, Hideki Ohdan
BACKGROUND: Despite the improvements of surgical techniques and postoperative management of patients with liver transplantation, biliary complications are one of the most common and important adverse events. We present a first case of choledochoduodenostomy using magnetic compression following a massive resection of the small intestine due to strangulated ileus after living donor liver transplantation. CASE PRESENTATION: The 54-year-old female patient had end-stage liver disease, secondary to liver cirrhosis, due to primary sclerosing cholangitis with ulcerative colitis...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28542114/predictors-of-pouchitis-after-ileal-pouch-anal-anastomosis-in-pediatric-onset-ulcerative-colitis
#16
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/28537459/superior-ophthalmic-vein-thrombosis-with-complete-loss-of-vision-as-a-complication-of-autoimmune-and-infective-conditions
#17
Jelena Juri Mandić, Krešimir Mandić, Danijela Mrazovac
PURPOSE: To present our experience in the management of superior ophthalmic vein thrombosis (SOVT), which is a rare, but extremely serious condition if not recognized and managed promptly and appropriately. METHODS: Two patients with septic and aseptic SOVT are presented. Clinical characteristics, radiographic features, management techniques, and outcomes are described. RESULTS: In the first case thrombosis occurred as a complication of functional endoscopic sinus surgery...
May 24, 2017: Ocular Immunology and Inflammation
https://www.readbyqxmd.com/read/28536228/clostridium-difficile-extraintestinal-abscess-a-rare-complication
#18
Vamsi Krishna Kantamaneni, Krishna C Gurram, Abhijit Kulkarni
Extraintestinal Clostridium difficile is rare. A 74-year-old man with a history of ulcerative colitis presented after a fall. Trauma work-up showed liver cirrhosis. Two days later he developed abdominal pain, distension, diarrhoea and leucocytosis. Stool tested positive for C. difficile CT abdomen showed pancolitis with toxic megacolon. Total abdominal colectomy and ileostomy with a rectal stump was performed. He was discharged, but was readmitted with sepsis. CT abdomen showed a 10.4×7.2 cm fluid collection in the pelvis...
May 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28533920/inflammatory-bowel-disease-efficient-remission-maintenance-is-crucial-for-cost-containment
#19
REVIEW
Giovanni C Actis, Rinaldo Pellicano
The inflammatory bowel diseases (IBD) are chronic incurable inflammatory disorders of the gut. Some 10% run a downhill course, requiring emergency medical support and often surgery; another small subset are monogenic, and, threatening pediatric patients, are the challenge of these days. The majority of the IBDs, however, are polygenic low-penetrance diseases, running a lifetime waxing-and-waning course. The prevalent trend is towards a slow worsening and steady cost increase. Each and all drugs of the available arsenal exhibit strengths and weaknesses: Mesalamines are chiefly effectively for mild-moderate colitis, and do not work in Crohn's; steroids do not control some 40% of the ulcerative colitis cases, and are not indicated for Crohn's; thiopurines are effective in the maintenance of the IBDs but do not prevent relapses on withdrawal; biologics are still being used empirically (not monitored) causing further increase of their cost over that of hospitalization...
May 6, 2017: World Journal of Gastrointestinal Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28533918/5-aminosalicylates-to-maintain-remission-in-crohn-s-disease-interpreting-conflicting-systematic-review-evidence
#20
EDITORIAL
Morris Gordon
5-Aminosalicylates are a class of anti-inflammatory agents that have been used for decades in inflammatory bowel disease. Whilst they are first line for induction and an option for maintenance of remission in ulcerative colitis, the picture in Crohn's disease is variable. For maintenance of remission, key Cochrane systematic reviews have found conflicting results between the medical and surgical induced contexts. In this piece, the possible reasons for this are considered. It is proposed that clinicians should consider 5-aminosalicylates agents an option to maintain remission post-surgery...
May 6, 2017: World Journal of Gastrointestinal Pharmacology and Therapeutics
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