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Restorative proctocolectomy

Ismail Hamzaoglu, Bilgi Baca, Eren Esen, Erman Aytac, Volkan Ozben, Afag Aghayeva, Ismail A Bilgin, Tayfun Karahasanoglu
In this study, we aimed to present our initial experience on totally robotic total restorative proctocolectomy in ulcerative colitis (UC) patients. Patients undergoing a totally robotic restorative total proctocolectomy with ileal J-pouch anal anastomosis for UC between January 2015 and November 2017 were included. The da Vinci Xi was used for the operations. Patient demographics, perioperative and short-term operative outcomes were evaluated. Ten patients were included. The median operative time was 380 minutes(range, 300 to 480 min)...
February 12, 2019: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Nora Bismar, Ashish S Patel, David T Schindel
BACKGROUND: Younger children are referred for surgical intervention in the treatment of ulcerative colitis (UC) and familial adenomatous polyposis (FAP). Outcome data in this population after a laparoscopic restorative proctocolectomy and Ileal pouch-anal anastomosis (LRS-IPAA) are limited. We reviewed our experience to determine if younger children would have similar functional outcomes. METHODS: After institutional review board approval, a review of children with FAP and UC undergoing LRS-IPAA at a children's hospital from 2002 to 2017 occurred...
January 30, 2019: Journal of Surgical Research
Essi K Karjalainen, Laura Renkonen-Sinisalo, Harri K Mustonen, Anna H Lepistö
AIM: Restorative proctocolectomy with ileal pouch-anal anastomosis is considered by many surgeons to be the standard procedure for the surgical management of ulcerative colitis. Controversy exists whether a covering ileostomy should be constructed or not. The aim of this study was to evaluate the outcomes and morbidity of patients with ulcerative colitis who underwent restorative proctocolectomy with or without a diverting ileostomy. METHOD: This is a retrospective study of a consecutive series of 510 patients with ulcerative colitis who were operated in Helsinki University Hospital between January 2005 and June 2016...
January 30, 2019: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Maria Widmar, Jordan A Munger, Alex Mui, Stephen R Gorfine, David B Chessin, Daniel A Popowich, Joel J Bauer
BACKGROUND: The safety of undiverted restorative proctocolectomy (RPC) is debated. This study compares long-term outcomes after pouch leak in diverted and undiverted RPC patients. METHODS: Data were obtained from a prospectively maintained registry from a single surgical practice. One-stage and staged procedures with an undiverted pouch were considered undiverted pouches; all others were considered diverted pouches. The outcomes measured were pouch excision and long-term diversion defined as the need for loop ileostomy at 200 weeks after pouch creation...
January 25, 2019: International Journal of Colorectal Disease
Petra Ganschow, Irmgard Treiber, Ulf Hinz, Martina Kadmon
INTRODUCTION: Restorative proctocolectomy and ileal pouch-anal reconstruction is the surgical standard for the majority of patients with familial adenomatous polyposis (FAP). The pouch-anal anastomosis may be performed handsewn after primary mucosectomy or by double stapling. Better functional results favour the latter; however, higher rates of remaining rectal mucosa with adenomas often necessitate secondary mucosectomy. Data on functional outcome after secondary mucosectomy is scarce...
January 24, 2019: Langenbeck's Archives of Surgery
F Borja de Lacy, Deborah Susan Keller, Beatriz Martin-Perez, Sameh Hany Emile, Manish Chand, Antonino Spinelli, Antonio M Lacy
BACKGROUND: The transanal approach to pelvic dissection has gained considerable traction and utilization continues to expand, fueled by the transanal total mesorectal excision (TaTME) for rectal cancer. The same principles and benefits of transanal pelvic dissection may apply to the transanal restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA)-the TaPouch procedure. Our goal was to review the literature to date on the development and current state of the TaPouch. MATERIALS AND METHODS: We performed a PubMed database search for original articles on transanal pelvic dissections, IPAA, and the TaPouch procedure, with a manual search from relevant citations in the reference list...
January 23, 2019: Surgical Endoscopy
Amy L Lightner, Ahmad Alsughayer, Zhen Wang, Nicholas P McKenna, Mohamed O Seisa, Christopher Moir
Background: Restorative proctocolectomy and ileal pouch anal anastomosis (IPAA) has become the procedures of choice for restoration of intestinal continuity in ulcerative colitis or familial adenomatous polyposis. This systematic review aims to assess short-term postoperative and long-term functional outcomes in pediatric patients undergoing IPAA. Methods: A literature search was performed for all publications of pediatric IPAA in which short- and long-term outcomes were reported...
January 18, 2019: Inflammatory Bowel Diseases
Miwa Satake, Hirotake Sakuraba, Hiroto Hiraga, Natsumi Tarakita, Yui Akemoto, Shinji Ota, Keisuke Hasui, Daisuke Nishiya, Shiro Hayamizu, Hidezumi Kikuchi, Manabu Sawaya, Daisuke Chinda, Tatsuya Mikami, Tadashi Shimoyama, Shinsaku Fukuda
We describe herein a case of severe relapsed pyoderma gangrenosum (PG) concomitantly with severe pouchitis treated by tacrolimus. A 25-year-old woman had undergone proctocolectomy with construction of ileo-anal pouch surgery for refractory ulcerative colitis (UC). She first developed PG with refractory pouchitis, and infliximab (IFX) was administered to induce remission due to resistance to glucocorticoid therapy. After achieving remission, IFX was stopped. Five years later, severe skin ulcers concomitantly with severe pouchitis recurred and treatment with 30 mg oral prednisolone (PSL) combined with topical tacrolimus showed partial improvement...
September 2018: Immunological medicine
Mark A Samaan, Katrina Forsyth, Jonathan P Segal, Djuna de Jong, Jasper LA Vleugels, Soad Elkady, Misha Kabir, Samantha Campbell, Klaartje Kok, David G Armstrong, Lawrence Penez, Aitor P Arenaza, Edward Seward, Roser Vega, Shameer Mehta, Farooq Rahman, Sara McCartney, Stuart Bloom, Kamal Patel, Richard Pollok, Edward Westcott, Amir Darakhshan, Andrew Williams, Ioannis Koumoutsos, Shuvra Ray, Joel Mawdsley, Simon Anderson, Jeremy D Sanderson, Evelien Dekker, Geert R D'Haens, Ailsa Hart, Peter M Irving
Background & Aims: There are no universally accepted guidelines regarding surveillance of UC patients after restorative proctocolectomy and ileal pouch-anal anastomosis (IPAA). There also exists a lack of validated quality assurance standards for performing pouchoscopy. To better understand IPAA surveillance practices in the face of this clinical equipoise, we carried out a retrospective cohort study at five IBD referral centres. Methods: Records of patients who underwent IPAA for UC or IBD-U were reviewed and patients with <1-year follow-up after restoration of intestinal continuity were excluded...
December 24, 2018: Journal of Crohn's & Colitis
Philip H Sossenheimer, Laura R Glick, Abraham Dachman, Kinga B Skowron, Michele Rubin, Konstantin Umanskiy, Radhika Smith, Lisa Cannon, Roger D Hurst, Russell D Cohen, Neil H Hyman, David T Rubin
BACKGROUND: Anastomotic complications after restorative total proctocolectomy with IPAA for ulcerative colitis alter functional outcomes and quality of life and may lead to pouch failure. Routine contrast enema of the pouch assesses anastomotic integrity before ileostomy reversal, but its clinical use is challenged. OBJECTIVE: The purpose of this research was to assess the relationship among preoperative clinical characteristics, abnormal pouchography, and long-term pouch complications...
November 28, 2018: Diseases of the Colon and Rectum
Christina C Huang, Frederick J Rescorla, Matthew P Landman
BACKGROUND: Ileal pouch-anal anastomosis (IPAA) is the standard surgical reconstruction for patients with familial adenomatous polyposis (FAP) and ulcerative colitis (UC) who undergo total proctocolectomy (TPC). Although patients receive the same reconstruction, their postoperative complications can differ. We hypothesize that indication for TPC and other preoperative clinical factors are associated with differences in postoperative outcomes following IPAA. METHODS: A retrospective cohort of pediatric patients who underwent proctocolectomy with IPAA from 1996 to 2016 was identified...
February 2019: Journal of Surgical Research
Mónica Llorente Barrio, Santiago García López, Yolanda Gilaberte Calzada, Rosario María Monzón Báez, Diego Casas Deza, Luis Javier Lamuela Calvo
No abstract text is available yet for this article.
November 20, 2018: Gastroenterología y Hepatología
Hiroki Ikeuchi, Motoi Uchino, Akira Sugita, Kitaro Futami, Kouhei Fukushima, Keisuke Hata, Kazutaka Koganei, Masato Kusunoki, Keiichi Uchida, Riichiro Nezu, Hideaki Kimura, Kenichi Takahashi, Michio Itabashi, Hitoshi Kameyama, Daijiro Higashi, Fumikazu Koyama, Takeshi Ueda, Tsunekazu Mizushima, Yasuo Suzuki
Background: Few studies have investigated surgical outcomes following a colectomy in pediatric patients with ulcerative colitis (UC). Purpose: This study aimed to determine long-term outcomes in a large cohort of pediatric patients who underwent proctocolectomy with ileal pouch-anal anastomosis (IPAA) for UC. Methods: Pediatric patients (<17 years old) who underwent surgery at 12 different hospitals in Japan between May 1979 and March 2015 were included in this study...
November 2018: Annals of gastroenterological surgery
Remil Simon, Keith Hollister, J Daniel Stanley, Shauna Lorenzo-Rivero
No abstract text is available yet for this article.
September 1, 2018: American Surgeon
Freeha Khan, Tracy L Hull, Bo Shen
Restorative proctocolectomy with ileal pouch-anal anastomosis has become the surgical treatment of choice for patients with refractory ulcerative colitis, colitis-associated dysplasia or familial adenomatous polyposis. There are various pouch disorders and associated complications. Floppy pouch complex is defined as the presence of pouch prolapse, afferent limb syndrome, enterocele, redundant loop and folding pouch on pouchoscopy, gastrografin pouchogram or defecography. Common clinical presentation includes dyschezia, bloating, abdominal pain, straining or the sense of incomplete evacuation...
November 2018: Gastroenterology Report
Naoyuki Tominaga, Sanae Tsuruta, Takahiro Yukimoto, Shimpei Shirai, Shinichi Ogata
This report presents the case of a 54-year-old man who had undergone restorative proctocolectomy with ileal pouch-anal anastomosis 15 years previously because of acute severe ulcerative colitis. After the operation, he experienced recalcitrant pouchitis and recurrent ulcer bleeding. There was a marked improvement in his symptoms following the administration of twice-daily budesonide 2mg foam injection for two months. Budesonide foam is suggested as a new therapy for pouchitis.
2018: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
Ilona Helavirta, Marja Hyöty, Heini Huhtala, Pekka Collin, Petri Aitola
OBJECTIVE: Restorative proctocolectomy is the procedure of choice in the surgical treatment of ulcerative colitis. Functional outcome is the key result of surgery. The aim of this study was to evaluate the long term-functional outcome after the procedure. MATERIAL AND METHODS: The study comprised 282 ulcerative colitis patients over 18 years of age who underwent restorative proctocolectomy between1985 and 2009. The median follow-up time was 13 years (range 4-28)...
October 22, 2018: Scandinavian Journal of Gastroenterology
Preeti Shashi, Bo Shen
BACKGROUND: Megapouch is a rare functional complication of restorative proctocolectomy with ileal pouch-anal anastomosis characterized by pouch ± small bowel dilatation with no evidence of obstruction on endoscopy and imaging. Little is known about clinical characteristics and outcomes of this entity. METHODS: We included all patients diagnosed with megapouch at our institution, identified from a pouch database. Data on baseline characteristics, management, and outcomes were documented and analyzed from electronic medical records...
October 16, 2018: Surgical Endoscopy
Georgios Exarchos, Linda Metaxa, Antonios Gklavas, Vassilis Koutoulidis, Ioannis Papaconstantinou
OBJECTIVES: Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the "gold standard" procedure for patients with ulcerative colitis (UC) requiring surgical intervention. A de-functioning ileostomy is usually performed, as a step for the IPAA procedure. The aim of this study is to present the methodology and results of the routine double assessment of IPAA integrity in asymptomatic patients prior to the ileostomy reversal and evaluate its necessity. METHODS: This is a retrospective study of 61 UC patients, who underwent IPAA construction, in 2010-2016...
October 15, 2018: European Radiology
D Mege, F Colombo, M E Stellingwerf, A Germain, L Maggiori, D Foschi, C J Buskens, A de Buck van Overstraeten, G Sampietro, A D'Hoore, W Bemelman, Y Panis
Background and Aims: Although laparoscopic a1pproach is associated with the reduction of adhesions, no data are available about risk factors for small bowel obstruction (SBO) after laparoscopic ileal pouch-anal anastomosis (IPAA). The objective is to identify risk factors for SBO after laparoscopic IPAA for inflammatory bowel disease (IBD). Methods: All consecutive patients undergoing laparoscopic IPAA for IBD in 4 European expert centres were included and divided into Groups A (SBO during follow up) and B (no SBO)...
October 11, 2018: Journal of Crohn's & Colitis
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