Apical Pouch Bridge Syndrome after IIeal J Pouch-Anal Anastomosis

Kusunoki, Masato; Okamoto, Tomoaki; Ikeuchi, Hiroki; Yoshikawa, Hitoshi; Yanagi, Hidenori; Shoji, Yasutsugu; Yamamura, Takehira; Utsunomiya, Joji

doi:10.1159/000172492

Cited by 5 publications

(4 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Cuando se ubican en colon, pueden presentar síntomas oclusivos o de constipación, existiendo algunos reportes en la literatura. [3][4][5] Si bien lo más frecuente es que se observen en colitis ulcerosa y enfermedad de Crohn, también pueden observarse en colitis severas por amebiasis, isquemia o disentería bacteriana. 2 Pueden verse también como consecuencia de anastomosis quirúrgicas, causando síntomas de constipación.…”

Section: Discussionunclassified

“…2 Pueden verse también como consecuencia de anastomosis quirúrgicas, causando síntomas de constipación. 3,4 También pueden formarse puentes mucosos a nivel de la anastomosis en el pouch en J ileoanal, descrito en la literatura como "síndrome de puente apical". 4 En el trabajo de Takagi et al, se realizó tratamiento quirúrgico de este tipo de puente por vía transanal con asistencia endoscópica.…”

Section: Discussionunclassified

“…3,4 También pueden formarse puentes mucosos a nivel de la anastomosis en el pouch en J ileoanal, descrito en la literatura como "síndrome de puente apical". 4 En el trabajo de Takagi et al, se realizó tratamiento quirúrgico de este tipo de puente por vía transanal con asistencia endoscópica. 6 En la literatura actual, no hemos encontrado casos reportados de puentes mucosos rectales tratados exclusivamente por vía endoscópica.…”

Section: Discussionunclassified

See 2 more Smart Citations

Causa infrecuente de trastorno evacuatorio por puente mucoso rectal en una paciente con enfermedad de Crohn

Secondo¹,

Canavesi²,

Arriola³

et al. 2020

Acta gastroenterol. latinoam.

View full text Add to dashboard Cite

show abstract

Section: Discussionunclassified

See 1 more Smart Citation

Causa infrecuente de trastorno evacuatorio por puente mucoso rectal en una paciente con enfermedad de Crohn

Secondo¹,

Canavesi²,

Arriola³

et al. 2020

Acta gastroenterol. latinoam.

View full text Add to dashboard Cite

show abstract

“…The pouch was stapled proximally and distally with 3-row staplers inserted at the mid-portion of the J-pouch. The septum at the pouch's apex was transected with a linear stapler to prevent apical pouch bridge syndrome [8]. After cleaning the pelvic floor with 4 liters of physiological saline, the pouch was delivered into the rectal muscular cuff.…”

Section: Operative Techniquesmentioning

confidence: 99%

Clinical Results of One-stage Restorative Proctocolectomy with J-pouch Anal Anastomosis in 300 Ulcerative Colitis Patients

Kuwahara

Ikeuchi

Bando

et al. 2020

J Anus Rectum Colon

Self Cite

View full text Add to dashboard Cite

Objectives: Restorative proctocolectomy and ileal pouch anal anastomosis (IPAA), with diverting ileostomy, are established ulcerative colitis (UC) treatments. The routine use of diverting ileostomy is controversial because of the risk of stoma closure and stoma related complications. In our institution, proctocolectomy and IPAA, with mucosectomy and handsewn anastomosis without diversion (one-stage IPAA), were performed for select patients with UC. The present study aimed to evaluate the clinical and functional outcomes of patients undergoing one-stage IPAA. Methods: Between April 1999 and July 2017, 300 patients underwent one-stage IPAA in our institution. The clinical notes and prognosis were reviewed retrospectively. Results: Postoperative complications (Clavien-Dindo classification grade ≥III) occurred in 18 patients (6.0%). The most common complication was anastomotic leakage (n = 9, 3%). There were 15 patients (5.0%) who required a defunctioning ileostomy. However, 13 patients successfully underwent ileostomy closure and achieved acceptable pouch function. Finally, two patients (0.6%) required pouch excision in this series. The cumulative pouch functional rate was 99.6% / 5 years and 99.2% / 10 years. Conclusions: One-stage IPAA is a good strategy for carefully selected patients with UC.

show abstract

Endoscopy-assisted Transanal Division of an Apical Pouch Bridge After Restorative Proctocolectomy With a J-shaped Ileal Pouch

Takagi

Nagata

Ishizuka

et al. 2008

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

View full text Add to dashboard Cite

Restorative proctocolectomy and J-shaped ileal pouch-anal anastomosis have been performed as a standard operation for ulcerative colitis. However, functional problems are sometimes troublesome in the postoperative period. The J pouch was constructed from 2 ileal limbs using the gastrointestinal anastomosis (GIA) stapler. A residual mucosal bridge remained because the stapler had a safety margin at the top of the cartridge. Apical pouch bridge is a residual septum above the ileoanal anastomosis. There are several reports of so-called apical pouch bridge syndrome due to outlet obstruction of the J-shaped ileal pouch by an apical bridge. Division of this septum can resolve the outlet obstruction. We describe a successful endoscopic procedure for division of an apical pouch bridge. An Endo-GIA stapler was introduced into the ileal pouch alongside the endoscope, and division of the apical bridge required a few firings of the Endo-GIA stapler under transanal endoscopic guidance. The symptoms related to the apical pouch bridge were resolved completely without creation of an ileostomy.

show abstract

Apical Pouch Bridge Syndrome after IIeal J Pouch-Anal Anastomosis

Cited by 5 publications

References 9 publications

Causa infrecuente de trastorno evacuatorio por puente mucoso rectal en una paciente con enfermedad de Crohn

Causa infrecuente de trastorno evacuatorio por puente mucoso rectal en una paciente con enfermedad de Crohn

Clinical Results of One-stage Restorative Proctocolectomy with J-pouch Anal Anastomosis in 300 Ulcerative Colitis Patients

Endoscopy-assisted Transanal Division of an Apical Pouch Bridge After Restorative Proctocolectomy With a J-shaped Ileal Pouch

Contact Info

Product

Resources

About