Long‐term surgical load in patients with ileal pouch‐anal anastomosis

Abstract

More than half of patients operated with restorative proctocolectomy will need surgical intervention within 20 years and the failure rate is more than 10%. The high risk of complications and failure inherent in the procedure should not be ignored.

Primary Sclerosing Cholangitis and Extraintestinal Manifestations in Patients with Ulcerative Colitis and Ileal Pouch–Anal Anastomosis

“…In the present study, mucosectomies were not more frequently performed in the PSC patients nor did they suffer more early anastomotic or pouch complications compared to other UC patients. In a previous study 22 of the same population of patients, no association between early pelvic sepsis and stapled or hand-sewn low anastomosis was found which is in accordance with the study of Lovegrove et al 23 Increased bleeding peri-and postoperatively may be related to the seriousness of liver affection. Bleeding and postoperative hematomas were not more frequently observed in our study.…”

Ileal Pouch Anal Anastomosis with Close Rectal Dissection Using Automated Vessel Sealers for Ulcerative Colitis: A Promising Alternative

“…A larger study with long-term follow-up will be needed to reliably assess the hypothesized benefits of CR-IPAA. There are twelve studies reporting to have used the close rectal dissection technique [14,15,16,17,18,28,29,30,31,32,33,34]. One study [34] has a population with both close rectal and TME, so the results of this study cannot be analyzed.…”

“…There are twelve studies reporting to have used the close rectal dissection technique [14,15,16,17,18,28,29,30,31,32,33,34]. One study [34] has a population with both close rectal and TME, so the results of this study cannot be analyzed. However, the five largest studies, with over 100 patients, show contradictory results; Rink et al [18] and Berry et al [14] show a very low leakage rate and no autonomic nerve damage, respectively, due to close rectal dissection.…”

Failed pelvic pouch substituted by continent ileostomy

“…During 1984–2007, a total of 317 patients underwent IPAA at our department. Pelvic pouch failure occurred in 25 patients (7.8%) [4]. In seven patients a CI was established.…”

“…Functional results are excellent and patient satisfaction is about 90% [3]. The rate of complications is not negligible, and in a significant proportion of the patients, repeated revisional surgery is necessary to obtain good functional results [4,5]. Although most complications can be handled satisfactorily by revisional surgery, failures do occur.…”