Ileal Pouch-Anal Anastomosis Surgery: Anatomy, Postoperative Complications, and Image-Guided Intervention

Uyeda, Jennifer W.; LeBedis, Christina A.; Penn, David R.; Murakami, Akira M.; Ramalingam, Vijay; Anderson, Stephan W.; Soto, Jorge A.; Gupta, Avneesh

doi:10.1053/j.sult.2013.03.003

Cited by 3 publications

(2 citation statements)

References 49 publications

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“…Factors contributing to portal vein thrombosis following pouch surgery include the hypercoagulable state of IBD patients, the inflammatory response secondary to pouchitis/sepsis, and dehydration due to a high output stoma/pouch. Other factors include the need to mobilise small bowel mesentery to its root, which can potentially result in endothelial stretch and injury and a subsequent thrombotic cascade[95].…”

Section: Complicationsmentioning

confidence: 99%

Ileal-anal pouches: A review of its history, indications, and complications

Ng¹,

Gonsalves²,

Sagar³

2019

WJG

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The ileal pouch anal anastomosis (IPAA) has revolutionised the surgical management of ulcerative colitis (UC) and familial adenomatous polyposis (FAP). Despite refinement in surgical technique(s) and patient selection, IPAA can be associated with significant morbidity. As the IPAA celebrated its 40 th anniversary in 2018, this review provides a timely outline of its history, indications, and complications. IPAA has undergone significant modification since 1978. For both UC and FAP, IPAA surgery aims to definitively cure disease and prevent malignant degeneration, while providing adequate continence and avoiding a permanent stoma. The majority of patients experience long-term success, but “early” and “late” complications are recognised. Pelvic sepsis is a common early complication with far-reaching consequences of long-term pouch dysfunction, but prompt intervention (either radiological or surgical) reduces the risk of pouch failure. Even in the absence of sepsis, pouch dysfunction is a long-term complication that may have a myriad of causes. Pouchitis is a common cause that remains incompletely understood and difficult to manage at times. 10% of patients succumb to the diagnosis of pouch failure, which is traditionally associated with the need for pouch excision. This review provides a timely outline of the history, indications, and complications associated with IPAA. Patient selection remains key, and contraindications exist for this surgery. A structured management plan is vital to the successful management of complications following pouch surgery.

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Section: Complicationsmentioning

confidence: 99%

Ileal-anal pouches: A review of its history, indications, and complications

Ng¹,

Gonsalves²,

Sagar³

2019

WJG

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“…По данным зарубежной литературы, колпроктэктомия с формированием J-образного тонкокишечного резервуара с илеоанальным анастомозом рекомендована пациентам с наличием множественных аденоматозных полипов во всех отделах толстой кишки [35,36]. При таком объеме оперативного вмешательства хорошие отдаленные результаты описаны у 58-95% больных [5,37,38].…”

Section: êëèíè÷åñêèé ìîíèòîðèíã è õèðóðãè÷åñêîå ëå÷åíèå ïàöèåíòîâ ñ Munclassified

MutYH-associated polyposis

Тобоева

Shelygin

Фролов

et al. 2019

Terapevticheskii arkhiv

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MutYH-associated polyposis is the only polyposis syndrome with an autosomal recessive type of inheritance, often phenotypically similar to a weakened form of familial adenomatous polyposis. For the development of the disease mutations in both alleles of the gene are required, but an increased risk of developing colorectal cancer in carriers of monoallelic mutations is noted. The diagnosis of MutYH-associated polyposis should be suspected in a patient with colorectal cancer over 45 years old on the background of polyps in the colon. The review presents modern algorithms for diagnostic and treatment of the disease.

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MR Enterography of the Ileoanal Pouch: Descriptive Radiologic Analysis With Endoscopic and Pathologic Correlation

Sahi

Lee

Moss

et al. 2015

American Journal of Roentgenology

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In patients who have undergone IPAA surgery, the MRE findings strongly correlate with the pouch endoscopic findings with high sensitivity and positive predictive value for pouch inflammation. Therefore, MRE is a useful noninvasive test performed without ionizing radiation that can be used to evaluate patients with clinical symptoms and possibly alleviate the need for endoscopy in a select patient population.

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Ileal Pouch-Anal Anastomosis Surgery: Anatomy, Postoperative Complications, and Image-Guided Intervention

Cited by 3 publications

References 49 publications

Ileal-anal pouches: A review of its history, indications, and complications

Ileal-anal pouches: A review of its history, indications, and complications

MutYH-associated polyposis

MR Enterography of the Ileoanal Pouch: Descriptive Radiologic Analysis With Endoscopic and Pathologic Correlation

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