Endoscopic management of obstructing pouch twist

Pokala, Sriya; Shen, Bo

doi:10.1093/gastro/goac039

Cited by 3 publications

(3 citation statements)

References 9 publications

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“…However, the pouch ulcer persisted. Attempts will be made to treat structural outlet obstructions, such as septectomy for pouch twist [ 7 ] and band ligation for distal pouch prolapse [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Solitary pouch ulcer syndrome—a newly recognized phenotype of the ileal pouch disorders

Shen,

Ko,

et al. 2023

Gastroenterology Report

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Section: Discussionmentioning

confidence: 99%

Solitary pouch ulcer syndrome—a newly recognized phenotype of the ileal pouch disorders

Shen,

Ko,

et al. 2023

Gastroenterology Report

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“…Patients are at risk of postoperative recurrence or pouch excision [ 4 , 5 ]. Less invasive, endoscopic approaches have been performed for the treatment of twisted pouches such as septectomy [ 9 ]. Here we described the first case in the literature in which symptomatic twisted pouch was successfully treated with endoscopic plication.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic plication for the treatment of twisted pouch

Shen

2023

Gastroenterology Report

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“…In patients with inflammatory bowel disease (IBD) for whom medical therapy is unsuccessful or who develop neoplasia, restorative proctocolectomy with ileal pouch–anal anastomosis (IPAA) is often indicated, as opposed to standard colectomy with permanent end ileostomy, as it preserves the natural defecation route and circumvents the need for a permanent abdominal stoma [ 1 , 2 ]. Although this procedure often leads to symptoms and quality-of-life improvement, it may be associated with complications, including inflammation of the pouch or rectal cuff, known as “pouchitis” and “cuffitis,” respectively [ 1 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

Association between mucosectomy and endoscopic outcomes in patients with ileal pouch–anal anastomosis

Hembree,

Shen,

Freedberg

2023

Gastroenterology Report

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Background In patients with inflammatory bowel disease (IBD) for whom medical therapy is unsuccessful or who develop colitis-associated neoplasia, restorative proctocolectomy with ileal pouch–anal anastomosis (IPAA) is often indicated. One consideration for surgeons performing this procedure is whether to create this anastomosis using a stapled technique without mucosectomy or using a hand-sewn technique with mucosectomy. This study tested the association between IPAA anastomosis technique and cuffitis and/or pouchitis, assessed endoscopically. Methods This was a retrospective cohort study. We included consecutive adult patients with IBD who had undergone IPAA and had received index pouchoscopies at Columbia University Irving Medical Center between 2020 and 2022. Patients were then followed up from this index pouchoscopy for ≤12 months to a subsequent pouchoscopy. The primary exposure was mucosectomy vs non-mucosectomy and the primary outcome was cuffitis and/or pouchitis, defined as a Pouch Disease Activity Index endoscopy subscore of ≥1. Results There were 76 patients who met study criteria including 49 (64%) who had undergone mucosectomy and 27 (36%) who had not. Rates of cuffitis and/or pouchitis were 49% among those with mucosectomy vs 41% among those without mucosectomy (P = 0.49). Time-to-event analysis affirmed these findings (log-rank P = 0.77). Stricture formation was more likely among patients with mucosectomy compared with those without mucosectomy (45% vs 19%, P = 0.02). Conclusions There was no association between anastomosis technique and cuffitis and/or pouchitis among patients with IBD. These results may support the selection of stapled anastomosis over hand-sewn anastomosis with mucosectomy.

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Endoscopic management of obstructing pouch twist

Cited by 3 publications

References 9 publications

Solitary pouch ulcer syndrome—a newly recognized phenotype of the ileal pouch disorders

Solitary pouch ulcer syndrome—a newly recognized phenotype of the ileal pouch disorders

Endoscopic plication for the treatment of twisted pouch

Association between mucosectomy and endoscopic outcomes in patients with ileal pouch–anal anastomosis

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