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Ileal pouch anal anastomosis

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https://www.readbyqxmd.com/read/28501251/dysplasia-and-cancer-in-inflammatory-bowel-disease
#1
REVIEW
Lyen C Huang, Amit Merchea
Inflammatory bowel disease is associated with an increased risk of dysplasia and cancer. Improvements in medical management and endoscopic surveillance have reduced these risks. Patients can develop cancer even in the absence of dysplasia or with indefinite or low-grade dysplasia. Most guidelines recommend starting surveillance colonoscopy 6 to 10 years after initial diagnosis with interval surveillance afterward every 1 to 5 years depending on risk and/or individual characteristics. Most patients should undergo total proctocolectomy with end ileostomy or reconstruction with ileal pouch anal anastomosis because segmental and subtotal resections carry a higher risk of metachronous cancers...
June 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28486255/intestinal-barrier-disruption-in-ileal-pouchitis-after-ileal-pouch-anal-anastomosis-in-a-rat-model
#2
Kai-Yu Li, Jian-Lin Wang, Yan-Yan Xu, Sen-Yang Gao, Ying-Ying Zhang, An-Qi He, Gang Liu
BACKGROUND: Pouchitis occurs in approximately 50% of patients with ulcerative colitis after ileal pouch-anal anastomosis (IPAA) but the pathogenesis remains unclear. We used a rat model of dextran sulfate sodium (DSS)-induced ileal pouchitis to examine whether intestinal barrier disruption plays a role in the development and progression of the disease. METHODS: Rats were randomly divided into DSS (underwent IPAA and administered 5% DSS orally), IPAA (underwent IPAA), and Sham groups (underwent switch abdominal surgery)...
May 5, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28485190/complications-and-morbidity-associated-with-loop-ileostomies-in-patients-with-ulcerative-colitis
#3
J Park, B Gessler, M Block, E Angenete
BACKGROUND AND AIMS: Loop ileostomies are frequently used as diversion of the fecal stream to protect a distal anastomosis. The aim of this study was to identify complications and morbidity related to loop ileostomies in patients with ulcerative colitis at a nonemergent setting. MATERIAL AND METHODS: Consecutive patients with ulcerative colitis who received a loop ileostomy at a tertiary referral center in Sweden from January 2006 until December 2012 were included and studied retrospectively...
May 1, 2017: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/28481854/paradoxical-impact-of-ileal-pouch-anal-anastomosis-on-male-and-female-fertility-in-patients-with-ulcerative-colitis
#4
Frederik R Pachler, Søren B Brandsborg, Søren Laurberg
BACKGROUND: Birth rates in males with ulcerative colitis and ileal pouch-anal anastomosis have not been studied. OBJECTIVE: This study aimed to estimate birth rates in males and females with ulcerative colitis and study the impact of ileal pouch-anal anastomosis. DESIGN: This was a retrospective registry-based cohort study that was performed over a 30-year period. SETTINGS: Records for parenting a child from the same period were cross-linked with patient records, and birth rates were calculated using 15 through 49 years as age limits...
June 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28481467/restorative-proctocolectomy-an-example-of-how-surgery-evolves-in-response-to-paradigm-shifts-in-care
#5
Feza H Remzi, Olga A Lavryk, Jean H Ashburn, Tracy L Hull, Ian C Lavery, David W Dietz, Hermann Kessler, James M Church
BACKGROUND: Surgical technique constantly evolves in response to the pressure of progress. Ileal pouch anal anastomosis (IPAA) is a good example. We analyzed the effect of changes in practice on the technique of IPAA and its outcomes. METHODS: Patients undergoing primary IPAA at this institution were divided into three groups by date of IPAA: those operated from 1983-1993, 1994-2004, and 2005 - 2015. Demographics, patient comorbidity, surgical techniques, post-operative outcomes, pouch function and quality of life were analyzed...
May 8, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28470559/functional-outcomes-following-laparoscopic-ileal-pouch-anal-anastomosis-in-patients-with-chronic-ulcerative-colitis-long-term-follow-up-of-a-case-matched-study
#6
Se-Jin Baek, Amy L Lightner, Sarah Y Boostrom, Kellie L Mathis, Robert R Cima, John H Pemberton, David W Larson, Eric J Dozois
BACKGROUND: Laparoscopic ileal pouch-anal anastomosis (L-IPAA) has been increasingly adopted over the last decade due to short-term patient-related benefits. Several studies have shown L-IPAA to be equivalent to open IPAA in terms of safety and short-term outcomes. However, few L-IPAA studies have examined long-term functional outcomes. We aimed to evaluate the long-term functional outcomes of L-IPAA as compared to open IPAA. METHODS: A previous case-matched cohort study at our institution compared short-term outcomes between L-IPAA and open IPAA from 1998 to 2004...
May 3, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28462237/endoscopic-fistulotomy-heals-a-y-shaped-entero-entero-cutaneous-fistula
#7
Helen Lee, Bo Shen
Patients may develop fistulas due to Crohn's disease or as a postoperative complication after restorative proctocolectomy with ileal pouch anal anastomosis. Unfortunately, the treatment of fistulas can be challenging. The current standard of care may include medical therapy and/or surgical intervention. However, endoscopic treatment for postoperative pouch complications has emerged as a valid alternative option. We describe a case of persistent drainage from a Y-shaped entero-entero-cutaneous fistula that resolved after endoscopic fistulotomy with needle knife...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28426474/pouch-related-symptoms-and-quality-of-life-in-patients-with-ileal-pouch-anal-anastomosis
#8
Edward L Barnes, Hans H Herfarth, Robert S Sandler, Wenli Chen, Elizabeth Jaeger, Van M Nguyen, Amber R Robb, Michael D Kappelman, Christopher F Martin, Millie D Long
BACKGROUND: Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) has become the standard surgical treatment for the majority of patients with inflammatory bowel disease (IBD) who require colectomy. We evaluated the prevalence of pouch-related symptoms among the Crohn's and Colitis Foundation of America Partners cohort and the effect of pouch-related symptoms on Patient-Reported Outcome Measurement Information System measures. METHODS: We performed analyses nested in the Crohn's and Colitis Foundation of America Partners cohort...
April 19, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28426453/indications-for-mode-of-delivery-in-pregnant-women-with-inflammatory-bowel-disease
#9
Kristin E Burke, Miriam J Haviland, Michele R Hacker, Scott A Shainker, Adam S Cheifetz
BACKGROUND: Reasons for the increased incidence of cesarean delivery among women with inflammatory bowel disease remain unclear. We assessed cesarean delivery incidence and factors influencing mode of delivery in women with inflammatory bowel disease. METHODS: We performed a 10-year retrospective cohort study of nulliparous women who delivered a singleton infant at our institution. We compared the risk of each mode of delivery in women with Crohn's disease and ulcerative colitis with women without inflammatory bowel disease...
May 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28426452/defining-the-most-appropriate-delivery-mode-in-women-with-inflammatory-bowel-disease-a-systematic-review
#10
Arthur Foulon, Jean-Louis Dupas, Charles Sabbagh, Julien Chevreau, Lionel Rebibo, Franck Brazier, Guillaume Bouguen, Jean Gondry, Mathurin Fumery
INTRODUCTION: High cesarean section (CS) rates are observed in patients with inflammatory bowel disease (IBD), but limited data are available to support this decision. We conducted a comprehensive review to evaluate the most appropriate mode of delivery in women with IBD according to disease phenotype and activity, as well as surgical history. MATERIALS AND METHODS: We searched MEDLINE (source PubMed) and international conference abstracts, and included all studies that evaluated digestive outcome after delivery in patients with IBD...
May 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28410344/preoperative-clostridium-difficile-infection-does-not-affect-pouch-outcomes-in-patients-with-ulcerative-colitis-who-undergo-ileal-pouch-anal-anastomosis
#11
Amy L Lightner, Chung Sang Tse, Kevin Quinn, John R Bergquist, Felicity Enders, Richard Pendegraft, Sahil Khanna, Laura Raffals
BACKGROUND: The operation of choice for patients with chronic ulcerative colitis (CUC) is restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA). Pouchitis is the most common complication after IPAA. The incidence of Clostridium difficile infection (CDI) is higher in CUC patients than the general population and can lead to significant disease flares and higher rates of colectomy. We sought to determine the risk of pouchitis in patients with precolectomy CDI and 90-day postoperative IPAA complications...
April 13, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28405717/-differential-indications-for-ileoanal-pouch-anastomosis-ulcerative-colitis-familial-adenomatous-polyposis-synchronous-colorectal-cancer-crohn-s-disease-constipation
#12
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...
April 12, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28387059/pouch-excision-indications-and-outcomes
#13
Amy L Lightner, Sheev Dattani, Eric J Dozois, Sara B Moncrief, John H Pemberton, Kellie L Mathis
INTRODUCTION: Resotrative proctolectomy (RPC) with Ileal-pouch anal anastomosis (IPAA) 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...
April 7, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28369422/ileal-pouch-anal-anastomosis-for-dysplasia-or-cancer-complicating-inflammatory-bowel-disease-is-total-mesorectal-excision-always-mandatory-an-analysis-of-36-consecutive-patients
#14
Chloé Coton, Léon Maggiori, Diane Mège, Clotilde Naudot, Justine Prost À la Denise, Yves Panis
Background & Aim: The extent of lymph node harvesting during surgery for colorectal neoplasm (dysplasia and/or cancer) complicating inflammatory bowel disease (IBD) is the matter of debate. This study aimed to assess the risk of invasive rectal cancer in patients undergoing ileal pouch-anal anastomosis (IPAA) for colonic neoplasm complicating IBD, and thus to clarify if a systematic total mesorectal excision (TME) should be systematically performed or not in those patients. Methods: From 1998 to 2015, all patients who underwent IPAA for colorectal neoplasm complicating IBD were included...
March 22, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/28346273/preoperative-extraintestinal-manifestations-associated-with-chronic-pouchitis-in-japanese-patients-with-ulcerative-colitis-after-ileal-pouch-anal-anastomosis-a-retrospective-study
#15
Keisuke Hata, Hiroaki Ishii, Hiroyuki Anzai, Soichiro Ishihara, Hiroaki Nozawa, Kazushige Kawai, Tomomichi Kiyomatsu, Toshiaki Watanabe
BACKGROUND: Pouchitis is a major problem after ileal pouch-anal anastomosis in patients with ulcerative colitis. Chronic pouchitis is particularly troublesome. This study aimed to identify risk factors for the development of chronic pouchitis in a Japanese population. METHODS: We retrospectively reviewed 100 patients who underwent pouchoscopy for a functioning ileal pouch. The diagnosis of pouchitis was made according to the modified pouchitis disease activity index...
March 24, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28333202/risk-of-rectal-neoplasia-after-colectomy-and-ileorectal-anastomosis-for-ulcerative-colitis
#16
Mathieu Uzzan, Julien Kirchgesner, Nadia Oubaya, Aurélien Amiot, Jean-Marc Gornet, Philippe Seksik, Stéphane Nancey, Eddy Cotte, Matthieu Allez, Gilles Boschetti, David Laharie, Nicola de Angelis, Maria Nachury, Anne-Laure Pelletier, Vered Abitbol, Mathurin Fumery, Antoine Brouquet, Anthony Buisson, Romain Altwegg, Jacques Cosnes, Yves Panis, Xavier Treton
Introduction-: Colectomy can be required in the management of ulcerative colitis (UC). While ileal pouch anal-anastomosis (IPAA) is the recommended reconstruction technique, ileorectal anastomosis (IRA) is still performed and might present some advantages. However, the risk of rectal neoplasia might limit its indication. The aims of our study were to determine the incidence of rectal neoplasias following IRA for UC and to identify risk factors associated with rectal carcinomas. Methods-: We performed a multicenter retrospective study including patients who underwent IRA for UC from 1960 to 2014 in 13 centers...
February 21, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/28315811/variant-two-stage-ileal-pouch-anal-anastomosis-an-innovative-and-effective-alternative-to-standard-resection-in-ulcerative-colitis
#17
Jennifer Samples, Krista Evans, Nicole Chaumont, Paula Strassle, Timothy Sadiq, Mark Koruda
BACKGROUND: Ulcerative colitis patients have been historically treated with standard single, two and three stage operative approaches. We perform a variant two-stage procedure beginning with total abdominal colectomy and end ileostomy followed by completion proctectomy and ileal pouch-anal anastomosis without a diverting loop ileostomy. The present study evaluates the effectiveness of this innovative alternative. STUDY DESIGN: Patients with ulcerative colitis admitted to UNC Hospital between 2003 and 2010 for IPAA were eligible for inclusion...
January 28, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28301430/etiopathogenesis-of-nephrolithiasis-in-ulcerative-colitis-patients-with-the-ileal-pouch-anal-anastomosis
#18
Zubin Arora, Saurabh Mukewar, Rocio Lopez, Debra Camino, Bo Shen, Phillip Hall
BACKGROUND: Our previous study showed that nephrolithiasis is a common complication in ulcerative colitis patients after ileal pouch anal anastomosis (IPAA). However, the pathogenesis of nephrolithiasis in IPAA patients has not been studied. The aim of this study was to compare urine and serum metabolic compositions in IPAA patients with nephrolithiasis and controls with IPAA and no nephrolithiasis. METHODS: Using cross-sectional study design, serum and 24-hour urine metabolic compositions were compared between IPAA patients with nephrolithiasis (the study group) and those without (the control group)...
May 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28301429/results-at-up-to-30-years-after-ileal-pouch-anal-anastomosis-for-chronic-ulcerative-colitis
#19
Amy L Lightner, Kellie L Mathis, Eric J Dozois, Dieter Hahnsloser, Edward V Loftus, Laura E Raffals, John H Pemberton
BACKGROUND: Ileal pouch-anal anastomosis (IPAA) has become the surgical procedure of choice for patients with chronic ulcerative colitis. No study to date has examined functional and quality-of-life outcomes 30 years after pouch construction. METHODS: Using data from a prospectively maintained database with annually distributed questionnaires, functional outcomes, pouch complications, and quality of life after IPAA were determined. RESULTS: Overall, 93...
May 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28259741/nonrelaxing-pelvic-floor-dysfunction-is-an-underestimated-complication-of-ileal-pouch-anal-anastomosis
#20
Kevin P Quinn, Chung Sang Tse, Amy L Lightner, Richard S Pendegraft, Felicity T Enders, Laura E Raffals
BACKGROUND & AIMS: Nonrelaxing pelvic floor dysfunction (N-RPFD), or dyssynergic defecation, is the paradoxical contraction and/or impaired relaxation of pelvic floor and anal muscles during defecation. Few studies have evaluated this disorder in patients with an ileal pouch-anal anastomosis (IPAA). We investigated the frequency of N-RPFD in patients with and without chronic pouchitis following IPAA and the effectiveness of biofeedback therapy within this population. METHODS: We conducted a retrospective study of all patients with an IPAA who underwent anorectal manometry between January 2000 and March 2015 (n = 111)...
March 1, 2017: Clinical Gastroenterology and Hepatology
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