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Ileal pouch anal anastomosis

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https://www.readbyqxmd.com/read/29456982/early-outcome-of-patient-with-ulcerative-colitis-who-received-high-dose-of-steroid-and-underwent-two-staged-total-proctocolectomy
#1
Hajar Khazraei, Alimohammad Bananzadeh, Seyed Vahid Hosseini
Background: Ulcerative colitis (UC) is an idiopathic inflammatory disorder. Currently, the final treatment is colectomy. The aim of this study was to investigate the outcomes of proctocolectomy in patients that used a high dose of prednisolone. Materials and Methods: Seventy-five patients presenting for surgical management of histopathologically proven UC. All patients were offered total proctocolectomy (TPC) with ileal pouch-anal anastomosis (IPAA). Patients were divided into two groups: low dose of steroids (Group A) and high dose of steroid (Group B) consumers...
2018: Advanced Biomedical Research
https://www.readbyqxmd.com/read/29434447/enteral-nutrition-combined-with-glutamine-promotes-recovery-after-ileal-pouch-anal-anastomosis-in-rats
#2
Yan-Yan Xu, An-Qi He, Gang Liu, Kai-Yu Li, Jian Liu, Tong Liu
AIM: To assess the effect of enteral nutrition (EN) supplemented with glutamine on recovery after ileal pouch-anal anastomosis (IPAA) in rats, to provide an experimental basis for nutritional support in patients with ulcerative colitis (UC) after IPAA. METHODS: Male Sprague-Dawley (SD) rats were randomly divided into three groups ( n = 8) after IPAA operation using a microsurgical technique. From the third postoperative day, rats in the control group, EN group, and immune nutrition (IN) group were fed standard rat chow, short peptide EN, and short peptide EN combined with glutamine ad libitum , respectively...
February 7, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29423501/association-of-sulindac-and-erlotinib-vs-placebo-with-colorectal-neoplasia-in-familial-adenomatous-polyposis-secondary-analysis-of-a-randomized-clinical-trial
#3
N Jewel Samadder, Scott K Kuwada, Kenneth M Boucher, Kathryn Byrne, Priyanka Kanth, Wade Samowitz, David Jones, Sean V Tavtigian, Michelle Westover, Therese Berry, Kory Jasperson, Lisa Pappas, Laurel Smith, Danielle Sample, Randall W Burt, Deborah W Neklason
Importance: Patients with familial adenomatous polyposis (FAP) are at markedly increased risk for colorectal polyps and cancer. A combination of sulindac and erlotinib led to a 71% reduction in duodenal polyp burden in a phase 2 trial. Objective: To evaluate effect of sulindac and erlotinib on colorectal adenoma regression in patients with FAP. Design, Setting, and Participants: Prespecified secondary analysis for colorectal adenoma regression was carried out using data from a double-blind, randomized, placebo-controlled trial, enrolling 92 patients with FAP, conducted from July 2010 to June 2014 in Salt Lake City, Utah...
February 8, 2018: JAMA Oncology
https://www.readbyqxmd.com/read/29422639/ileal-pouch-of-ulcerative-colitis-and-familial-adenomatous-polyposis-patients-exhibit-modulation-of-autophagy-markers
#4
Nielce Maria Paiva, Lívia Bitencourt Pascoal, Leandro Minatel Vidal Negreiros, Mariana Portovedo, Andressa Coope, Maria de Lourdes Setsuko Ayrizono, Claudio Saddy Rodrigues Coy, Marciane Milanski, Raquel Franco Leal
Total retocolectomy with ileal pouch-anal anastomosis (IPAA) is the surgery of choice for patients with ulcerative colitis (UC) that are refractory to clinical treatment. Pouchitis is one of the most common complications after this procedure. Defects in autophagy have been reported in inflammatory bowel diseases. However, there are no studies on the IP. Therefore, we studied markers for autophagy in the IP mucosa of UC and FAP patients comparing them to controls with a normal distal ileum. Sixteen patients with IP in "J" shape, asymptomatic and with endoscopically normal IP were evaluated...
February 8, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29394669/-a-case-of-local-recurrence-with-negative-fdg-pet-findings-after-a-total-proctocolectomy-for-ulcerative-colitis-associated-with-colon-cancer-with-retroperitoneal-penetration
#5
Masumi Kumakura, Toshiro Ogura, Yu Muta, Tetsuya Ito, Azusa Yamamoto, Kunihiko Amano, Toru Ishiguro, Minoru Fukuchi, Erito Mochiki, Hideyuki Ishida
We report the case of a 55-year-old man who successfully underwent resection of a recurrence of ulcerative colitis(UC)- associated colon cancer located in the pancreatic body and left kidney. The patient had undergone an emergency laparotomy (total proctocolectomy with stapled ileal-pouch anal anastomosis)for the treatment of a descending colon cancer with retroperitoneal penetration associated with UC at the age of 50 years. At that time, histological examinations revealed a mucinous carcinoma that was classified as Stage II colon cancer...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29391089/abdominal-visceral-fat-area-and-chronic-pouchitis-after-ileal-pouch-anal-anastomosis
#6
Vivek Pandrangi, Daniel Mandel, Norman Gellada, Dionisio Mieses, Cindy Kallman, Karen Zaghiyan, Phillip Fleshner
Chronic pouchitis (CP) after ileal pouch-anal anastomosis is a significant clinical problem. Adipose tissues produce antiinflammatory cytokines and chemokines. We evaluated the association between abdominal visceral fat area (VFA) and CP. Patients with a preoperative CT evaluation were included. The diagnosis of CP was confirmed in all cases by endoscopy with afferent ileal limb intubation. Patients were allocated into groups of high VFA and low VFA. The study cohort of 52 patients had a median body mass index of 22 (range, 14-32)...
October 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29362331/-surgical-case-of-ulcerative-colitis-accompanied-with-rectal-cancer-combined-with-transanal-minimally-invasive-surgery
#7
Hideaki Kawakita, Kenji Katsumata, Yoshiaki Osaka, Hitoshi Saito, Kazuhiko Tamura, Tomoki Shirota, Kenta Kasahara, Minoru Kuwabara, Masatoshi Shigoka, Takaaki Matsudo, Masanobu Enomoto, Tetsuo Ishizaki, Masayuki Hisada, Kazuhiko Kasuya, Akihiko Tsuchida
A46 -year-old man developed ulcerative colitis at the age of 19 years. Although the colitis was medically treated, it relapsed and repeated over time. Periodic lower gastrointestinal endoscopy revealed lower rectal cancer, and he was referred to our department of surgery. Previous steroid therapy induced diabetes, and he was obese, with a height of 170.3 cm, weight of 89.6 kg, and BMI of 30.89 kg/m2, indicating that laparoscopic dissection near the anus would be difficult to perform. Therefore, the patient was scheduled for transanal minimally invasive surgery(TAMIS)...
January 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29361101/systematic-review-with-meta-analysis-anti-tnf-therapy-in-refractory-pouchitis-and-crohn-s-disease-like-complications-of-the-pouch-after-ileal-pouch-anal-anastomosis-following-colectomy-for-ulcerative-colitis
#8
Mathilde Huguet, Bruno Pereira, Marion Goutte, Félix Goutorbe, Anne Dubois, Gilles Bommelaer, Anthony Buisson
Background: Inflammatory complications including chronic refractory pouchitis and Crohn's disease (CD)-like complications of the pouch are common complications after ileal pouch-anal anastomosis (IPAA) following colectomy for ulcerative colitis (UC). We performed a systematic review and meta-analysis to evaluate the efficacy of anti-TNF therapy in distinguishing patients with chronic refractory pouchitis from those with CD-like complications of the pouch. Methods: We performed a systematic literature search to identify articles and abstracts reporting anti-TNF agents efficacy in treating inflammatory complications of the pouch after IPAA for UC...
January 18, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29351114/sexual-and-reproductive-issues-and-inflammatory-bowel-disease-a-neglected-topic-in-men
#9
Mariangela Allocca, Daniela Gilardi, Gionata Fiorino, Federica Furfaro, Laurent Peyrin-Biroulet, Silvio Danese
There has been considerable literature on sexual issues in women with inflammatory bowel disease (IBD), but relatively little attention has been paid to these aspects in men. To review the available literature and to provide the best management of sexual and reproductive issues in male patients with IBD. The scientific literature on sexual and reproductive issues in men with IBD was reviewed. Several factors, including surgical and medication treatments, disease activity, lifestyle, and psychological factors, may play a role in the development of infertility and sexual dysfunction and may negatively impact pregnancy outcomes...
January 18, 2018: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29325789/long-term-outcomes-following-ileal-pouch-anal-anastomosis-in-patients-with-indeterminate-colitis
#10
Uri Netz, Norman J Galbraith, Stephen O'Brien, Jane Carter, Stephen Manek, Robert E Petras, Susan Galandiuk
BACKGROUND: The advisability of performing ileal pouch-anal anastomosis for patients with indeterminate colitis is debated. Indeterminate colitis is found in up to 15% of inflammatory bowel disease colectomy specimens. We determined long-term outcomes in patients diagnosed with indeterminate colitis undergoing ileal pouch-anal anastomosis. METHODS: Fifty-six patients were included with a mean follow-up of 14 ± 7 years. Long-term behavior was defined based on surgeon assessment as "Crohn disease-like" in patients who subsequently developed clear signs of Crohn disease and as "non-Crohn disease-like...
January 8, 2018: Surgery
https://www.readbyqxmd.com/read/29324375/cancer-in-an-unexpected-site-post-pouch-surgery-for-familial-adenomatous-polyposis-fap
#11
Omar A Alwahbi, Alaa S Abduljabbar, Lucman A Anwer
INTRODUCTION: Familial Adenomatous Polyposis (FAP) is a hereditary condition characterized by multiple colorectal adenomatous polyps. FAP is the most common adenomatous polyposis syndrome. Restorative proctocolectomy is the most commonly performed surgical procedure performed for patients suffering from FAP with different options for anastomosis, namely ileorectal anastomosis (IRA) or ileal pouch anal anastomosis (IPAA). The occurrence of adenomas is a common finding during follow up and surveillance post surgery for these patients...
December 28, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29302751/primary-fecal-diversion-and-bowel-dysfunction-in-restorative-proctocolectomy-for-ulcerative-colitis-a-nationwide-cross-sectional-study
#12
Anders Mark-Christensen, Søren Brandsborg, Søren Laurberg
PURPOSE: The aim of this study was to explore the effects of primary fecal diversion on the risk of pouch dysfunction. METHODS: Patients operated with an ileal pouch-anal anastomosis in Denmark in 2000-2010 were identified and validated bowel function questionnaires retrieved from a cross-sectional study. Multivariate logistic regression analysis was performed to determine the effect of primary fecal diversion on pouch dysfunction. A diagnostic or procedural code for intraabdominal abscesses and fistulas, occurring within 1 year after pouch creation, and anastomotic leakage or extremely early-onset pouchitis within 30 days of surgery defined a pelvic complication...
January 4, 2018: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29285681/outcomes-of-ileal-pouch-anal-anastomosis-without-primary-diverting-loop-ileostomy-if-postoperative-sepsis-develops
#13
O A Lavryk, T L Hull, L C Duraes, L Stocchi, J H Ashburn, D Liska, E Gorgun, H Kessler
BACKGROUND: The aim of the present study was to assess the short-term and long-term consequences of diverting loop ileostomy (DLI) omission in ileal pouch-anal anastomosis (IPAA) surgery complicated by postoperative pelvic sepsis. METHODS: This was a retrospective review of a prospectively maintained database. Of 4031 patients who underwent IPAA in 1983-2014, 357 developed IPAA-related pelvic sepsis with or without anastomotic dehiscence. Patients with Crohn's disease or cancer were excluded...
December 28, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/29276421/adaptive-returns-of-deficient-systemic-plasma-immunoglobulin-g-levels-as-rehabilitation-biomarker-after-emergency-colectomy-for-fulminant-ulcerative-colitis
#14
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
https://www.readbyqxmd.com/read/29240877/prepouch-ileitis-after-ileal-pouch-anal-anastomosis-patterns-of-presentation-and-risk-factors-for-failure-of-treatment
#15
Matteo Rottoli, Carlo Vallicelli, Eleonora Bigonzi, Paolo Gionchetti, Fernando Rizzello, Massimo P Di Simone, Gilberto Poggioli
Background and Aims: There is a lack in the literature about prepouch ileitis [PI], in particular regarding risk factors associated with failure of the medical treatment. Aim of the study is to analyse the characteristics of PI patients and to compare those who required surgery with those who were successfully treated with conservative therapy. Methods: All cases presenting a diagnosis of PI were included and analysed. Patients eventually requiring surgery were compared with those who were managed conservatively, for symptoms of presentation, endoscopic characteristics, and rate of response to medical treatment...
October 9, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/29234962/the-functional-outcome-and-factors-influencing-the-quality-of-life-after-ileal-pouch-anal-anastomosis-in-patients-with-ulcerative-colitis
#16
Kazuhiro Watanabe, Munenori Nagao, Hideyuki Suzuki, Hideaki Karasawa, Shinobu Ohnuma, Hiroaki Musha, Yuji Funayama, Takashi Kamei, Takeshi Naitoh, Michiaki Unno
PURPOSE: The aim of this study was to assess the bowel function and quality of life (QOL) in patients with ulcerative colitis (UC) after total proctocolectomy with ileal pouch anal anastomosis (IPAA). METHODS: Two questionnaires ["Questionnaire sheet on the bowel function" and "Inflammatory bowel disease questionnaire (Japanese IBDQ)"] were sent to 121 patients with UC who underwent IPAA at Tohoku University Hospital. Seventy-nine patients (65%) participated in the study...
December 12, 2017: Surgery Today
https://www.readbyqxmd.com/read/29208550/transabdominal-salvage-surgery-after-pouch-failure-in-a-tertiary-center-a-case-matched-study
#17
Matteo Rottoli, Carlo Vallicelli, Paolo Gionchetti, Fernando Rizzello, Luca Boschi, Gilberto Poggioli
BACKGROUND: Salvage surgery after failure of ileal pouch-anal anastomosis (IPAA) could be offered to selected patients. However, the results vary widely in different centers. AIMS: To assess the outcomes of salvage surgery by comparison with a control group matched for confounding variables. METHODS: From a prospective database of 1286 IPAA, patients undergoing transabdominal salvage surgery were compared for perioperative and functional outcomes and quality of life (QOL) to a 1:3 control group of primary IPAA cases...
November 26, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29164476/diverticular-colitis-with-progression-to-ulcerative-colitis-after-sigmoidectomy
#18
Atsuyo Ikeda, Tsunekazu Mizushima, Yutaro Egashira, Hidekazu Takahashi, Norikatsu Miyoshi, Naotsugu Haraguchi, Taishi Hata, Chu Matsuda, Yuichiro Doki, Masaki Mori
Diverticular colitis is chronic inflammation of the colon where diverticula are present. The endoscopic and histopathological findings of this disease are sometimes similar to those of ulcerative colitis, and several reports describe cases of diverticular colitis that progressed to typical ulcerative colitis. A 77-year-old woman with intramesenteric penetration of the sigmoid diverticulum underwent low anterior resection. One month later, the patient experienced anastomotic leakage, and transverse colostomy was performed...
November 21, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29155985/a-systematic-review-the-management-and-outcomes-of-ileal-pouch-strictures
#19
Jonathan P Segal, Guy Worley, Samuel O Adegbola, Kapil Sahnan, Philip Tozer, Phillip F C Lung, Omar D Faiz, Susan K Clark, Ailsa L Hart
Background: Restorative proctocolectomy with ileal pouch-anal anastomosis removes the diseased tissue in ulcerative colitis but also allows gastrointestinal continuity and stoma-free living. Pouch strictures are a complication with a reported incidence of 5-38%. The three areas where pouch strictures occur are in the pouch inlet, mid-pouch and pouch-anal anastomosis. Aim: To undertake a systematic review of the literature and to identify management strategies available for pouch-anal, mid-pouch and pre-pouch ileal strictures and their outcomes...
November 16, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/29147895/routine-virtual-ileostomy-following-restorative-proctocolectomy-for-familial-adenomatous-polyposis
#20
Peter C Ambe, Hubert Zirngibl, Gabriela Möslein
BACKGROUND: Anastomotic leakage (AL) is the most feared complication in colorectal surgery. A diverting ileostomy is routinely used to prevent or reduce morbidity and mortality following AL. However, a diverting ileostomy cannot prevent AL. Besides, diverting ileostomy might be associated with relevant complications. Herein, we introduce the virtual ileostomy as an alternative to diverting ileostomy in patients undergoing restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) for familial adenomatous polyposis (FAP)...
November 16, 2017: World Journal of Surgery
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