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Ileal pouch anal anastomosis

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https://www.readbyqxmd.com/read/28812104/-laparoscopic-proctocolectomy-technique-restorative-proctocolectomy-with-ileal-pouch-anal-anastomosis-in-ulcerative-colitis-video-article
#1
REVIEW
B Jansen-Winkeln, O Lyros, A Lachky, N Teich, I Gockel
Laparoscopic restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) constitutes a curative treatment option for therapy-refractory ulcerative colitis. A two-stage procedure with loop ileostomy at the time of IPAA is the most frequent variant of surgery. The aim of the procedure is the complete removal of the colon and rectum with simultaneous restoration of gastrointestinal continuity and preservation of continence functions. Long-term quality of life following laparoscopic proctocolectomy with IPAA is good and comparable with a healthy reference population...
August 15, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28765694/lactobacillus-acidophilus-alleviates-pouchitis-after-ileal-pouch-anal-anastomosis-in-rats
#2
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/28742696/transanal-versus-transabdominal-minimally-invasive-completion-proctectomy-with-ileal-pouch-anal-anastomosis-in-ulcerative-colitis-a-comparative-study
#3
Anthony de Buck van Overstraeten, Anders Mark-Christensen, Karin A Wasmann, Vivian P Bastiaenen, Christianne J Buskens, Albert M Wolthuis, Koen Vanbrabant, André D'hoore, Willem A Bemelman, Anders Tottrup, Pieter J Tanis
OBJECTIVE: This study aims to compare surgical outcome of transanal ileal pouch-anal anastomosis (ta-IPAA) with transabdominal minimal invasive approach in ulcerative colitis (UC), using the comprehensive complication index (CCI). BACKGROUND: Recent evolutions in rectal cancer surgery led to transanal dissection of the rectum resulting in a better exposure of the distal rectum and presumed better outcome. The same approach was introduced for patients with UC, resulting in decreased invasiveness...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28705784/laparoscopic-proctocolectomy-with-ileal-j-pouch-anal-anastomosis-in-children
#4
Ufuk Ateş, Ergun Ergün, Gülnur Göllü, Gönül Küçük, Aydın Yağmurlu
BACKGROUND/AIMS: We aimed to evaluate postoperative fecal incontinence scales of children who underwent laparoscopic proctocolectomy and ileal J-pouch anastomosis for familial adenomateous polyposis (FAP) and inflammatory bowel disease (IBD). MATERIALS AND METHODS: Fecal incontinence scores were collected at 3 months post-surgery. A retrospective chart review was also performed to obtain the demographic data and operative technical details. RESULTS: The postoperative Wexner Fecal Incontinence Score was 0 in 9 of 11 patients and satisfactory in the remaining two...
July 13, 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28695880/hand-assisted-laparoscopic-restorative-proctocolectomy-with-ileal-pouch-anal-anastomosis-for-ulcerative-colitis
#5
Pengcheng Zhu, Chungen Xing
INTRODUCTION: In this study, we aimed to evaluate the feasibility and safety of undergoing restorative proctocolectomy through ileal pouch-anal anastomosis (RPC-IPAA) with hand-assisted laparoscopic (HALS) in patients with ulcerative colitis (UC). PATIENTS AND METHODS: We reviewed 40 consecutive patients who underwent RPC-IPAA with HALS or open technique for treatment of UC between 2010 and 2013. Moreover, the intra-/post-operative outcomes were compared. RESULTS: We found the median operative time was significantly longer in the HALS group while the blood loss was significantly less in patients with HALS than with open surgery...
July 7, 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28684935/the-role-of-temporary-fecal-diversion
#6
REVIEW
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
https://www.readbyqxmd.com/read/28667683/pouch-failures-following-ileal-pouch-anal-anastomosis-for-ulcerative-colitis
#7
Anders Mark-Christensen, Rune Erichsen, Søren Brandsborg, Frederik Rønne Pachler, Charlotte Buchard Nørager, Niels Johansen, Jørn Helmut Pachler, Ole Thorlacius-Ussing, Mie Dilling Kjaer, Niels Qvist, Louise Preisler, Jens Hillingsø, Jacob Rosenberg, Søren Laurberg
BACKGROUND: The ileal pouch-anal anastomosis is a procedure offered to patients with ulcerative colitis who opt for restoration of bowel continuity. The aim of this study was to determine the risk of pouch failure and ascertain risk factors associated with failure. METHOD: 1,991 patients with ulcerative colitis operated with ileal pouch-anal anastomosis in Denmark in the period 1980-2013 were included. Pouch failure was defined as excision of the pouch or presence of a stoma un-reversed within one year after its creation...
July 1, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28664652/laparoscopic-ileopexy-for-afferent-limb-syndrome-after-ileal-pouch-anal-anastomosis
#8
Yoshiki Okita, Toshimitsu Araki, Junichiro Hiro, Satoru Kondo, Hiroyuki Fujikawa, Shigeyuki Yoshiyama, Mikihiro Inoue, Yuji Toiyama, Minako Kobayashi, Masaki Ohi, Yasuhiro Inoue, Keiichi Uchida, Yasuhiko Mohri, Masato Kusunoki
Afferent limb syndrome (ALS) is caused by an obstruction of the afferent intestinal limb after ileal pouch-anal anastomosis. Here, we describe the first case of ALS to be successfully treated by a laparoscopic approach. A 27-year-old man underwent ileal pouch-anal anastomosis for ulcerative colitis. He was subsequently diagnosed with ALS and underwent ileopexy with laparotomy at 33 years old. Then, 21 months after the first ileopexy, he underwent laparoscopic ileopexy for ALS recurrence. The operative findings revealed a shortened fixed portion of the afferent limb adhering to the right pelvic retroperitoneum, which was regarded as the cause of the acute angulation...
June 30, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28662525/colonic-histological-criteria-predict-development-of-pouchitis-after-ileal-pouch-anal-anastomosis-for-patients-with-ulcerative-colitis
#9
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/28649762/the-usefulness-of-the-h-pouch-configuration-in-salvage-surgery-for-failed-ileal-pouches
#10
H Hande Aydinli, Colin Peirce, Erman Aytac, Feza Remzi
AIM: Abdominal salvage surgery for a failed ileal pouch-anal anastomosis (IPAA) is safe and feasible in experienced hands. When salvaging an ileal pouch or creating a new J, S or W-pouch may not be feasible, construction of an H-pouch may be the final option. This study reports a single colorectal surgeon's experience on H-pouch anal anastomosis in patients referred with a failed ileal pouch. METHOD: Patients undergoing transabdominal salvage surgery with H-pouch formation for a failed pouch from February 2012 to May 2016 were evaluated...
June 26, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28633443/nod2-genetic-variants-predispose-one-of-two-familial-adenomatous-polyposis-siblings-to-pouchitis-through-microbiome-dysbiosis
#11
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/28614561/association-of-preoperative-anti-tumor-necrosis-factor-therapy-with-adverse-postoperative-outcomes-in-patients-undergoing-abdominal-surgery-for-ulcerative-colitis
#12
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...
August 16, 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
#13
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/28600635/altered-expression-of-micrornas-in-patients-with-pouchitis-after-restorative-proctocolectomy
#14
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...
June 9, 2017: Surgery Today
https://www.readbyqxmd.com/read/28599590/predictors-of-quality-of-life-after-ileal-pouch-anal-anastomosis-in-patients-with-ulcerative-colitis
#15
Sherif Abolfotouh, Tero Rautio, Kai Klintrup, Ilona Helavirta, Jyrki Mäkelä
OBJECTIVES: Predictors of the postoperative quality of life (QoL) following ileal pouch anal anastomosis (IPAA) have not been thoroughly investigated. This study was planned to assess the postoperative QoL following IPAA and to identify its predictors using the 15D instrument. MATERIALS AND METHODS: A retrospective cohort study was conducted on IPAA-operated patients with ulcerative colitis in two Finnish tertiary hospitals during the period 1985-2014 (n = 485)...
June 9, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28566881/inflammatory-bowel-disease-in-liver-transplanted-patients
#16
REVIEW
Tajana Filipec Kanizaj, Maja Mijic
Most common hepatobiliary manifestation of inflammatory bowel disease (IBD) are primary sclerosing cholangitis (PSC) and autoimmune hepatitis, ranking them as the main cause of liver transplantation (LT) in IBD setting. Course of pre-existing IBD after LT differs depending on many transplant related factors. Potential risk factors related to IBD deterioration after LT are tacrolimus-based immunosuppressive regimens, active IBD and cessation of 5-aminosalicylates at the time of LT. About 30% patients experience improvement of IBD after LT, while approximately the same percentage of patients worsens...
May 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28542114/predictors-of-pouchitis-after-ileal-pouch-anal-anastomosis-in-pediatric-onset-ulcerative-colitis
#17
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...
September 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28501251/dysplasia-and-cancer-in-inflammatory-bowel-disease
#18
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
#19
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
#20
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
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