Rectal eversion: safe and effective way to achieve low transaction in minimally invasive Ileal pouch-anal anastomosis surgery, short- and long-term outcomes

Cataneo, Jose L.; Mowschenson, Peter; Cataldo, Thomas E.; Poylin, Vitaliy

doi:10.1007/s00464-019-06896-7

Cited by 3 publications

(1 citation statement)

References 12 publications

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“… 19 , 46 , 49 , 54 Anastomotic leak was defined as any defect at the anastomotic site confirmed by imaging or during surgical reintervention in 7 studies 16 , 20 , 23 , 24 , 55 , 56 and was undefined in 9 studies. 21 , 32 , 33 , 36 , 41 , 48 , 49 , 52 , 53 Pelvic sepsis included pelvic abscesses with or without anastomotic leak 20 , 23 , 31 , 32 , 36 , 39 , 41 , 43 , 46 , 52 in 10 studies; included anastomotic leaks, pelvic abscesses, and fistulas in 2 studies 21 , 45 ; and was undefined in 4 studies. 34 , 37 , 47 , 53 Fistula was defined as a fistula originating from anywhere in the pouch in 10 studies 16 , 20 , 23 , 31 , 33 , 34 , 39 , 44 , 50 , 53 ; originating from the anastomosis only in 1 study 48 ; and was undefined in 7 studies.…”

Section: Resultsmentioning

confidence: 99%

Ileal Pouch-anal Anastomosis Complications and Pouch Failure

Heuthorst

Wasmann

Reijntjes

et al. 2021

Annals of Surgery Open

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Objective: This systematic review aims to assess the incidence of pouch failure and the correlation between ileal pouch-anal anastomosis (IPAA)-related complications and pouch failure. Background: Previous studies demonstrated wide variation in postoperative complication rates following IPAA. Methods: A systematic review was performed by searching the MEDLINE, EMBASE, and Cochrane Library databases for studies reporting on pouch failure published from January 1, 2010, to May 6, 2020. A meta-analysis was performed using a random-effects model, and the relationship between pouch-related complications and pouch failure was assessed using Spearman’s correlations. Results: Thirty studies comprising 22,978 patients were included. Included studies contained heterogenic patient populations, different procedural stages, varying definitions for IPAA-related complications, and different follow-up periods. The pooled pouch failure rate was 7.7% (95% confidence intervals: 5.56–10.59) and 10.3% (95% confidence intervals: 7.24–14.30) for studies with a median follow-up of ≥5 and ≥10 years, respectively. Observed IPAA-related complications were anastomotic leakage (1–17%), pelvic sepsis (2–18%), fistula (1–30%), stricture (1–34%), pouchitis (11–61%), and Crohn’s disease of the pouch (0–18%). Pelvic sepsis (r = 0.51, P < 0.05) and fistula (r = 0.63, P < 0.01) were correlated with pouch failure. A sensitivity analysis including studies with a median follow-up of ≥5 years indicated that only fistula was significantly correlated with pouch failure (r = 0.77, P < 0.01). Conclusions: The single long-term determinant of pouch failure was pouch fistula, which is a manifestation of a chronic leak. Therefore, all effort should be taken to prevent an acute leak from becoming a chronic leak by early diagnosis and proactive management of the leak. Mini abstract: This systematic review aims to assess the incidence of pouch failure and the correlation between IPAA-related complications and pouch failure. Long-term pouch failure was correlated with fistula, suggesting that early septic complications may result in fistula formation during long-term follow-up, leading to an increased risk of pouch failure.

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Section: Resultsmentioning

confidence: 99%

Ileal Pouch-anal Anastomosis Complications and Pouch Failure

Heuthorst

Wasmann

Reijntjes

et al. 2021

Annals of Surgery Open

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Surgery for ulcerative colitis

Ochoa,

McMahon

2024

Seminars in Pediatric Surgery

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Rectal Eversion as an Anus-sparing Technique in Laparoscopic Low Anterior Resection With Double Stapling Anastomosis: Long-term Functional Results

Karagul,

Senol,

Karakose

et al. 2024

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Background: Rectal eversion (RE) is a natural orifice specimen extraction (NOSE) method that allows anus-sparing resection in very low rectal tumors. This study aims to share the long-term results of RE in laparoscopic rectal resection performed with double stapling anastomosis. Materials and Methods: A single-center retrospective cohort study was conducted for patients who underwent laparoscopic low anterior resection with RE. Age, sex, body mass index, American Society of Anesthesiologists (ASA) classification, type of surgery, distance of the tumor to the dentate line, specimen extraction site, cancer stage, preoperative chemoradiotherapy, postoperative complications, and postoperative clinical follow-up findings were recorded. Incontinence was assessed using the Wexner score (WS). Low anterior resection syndrome (LARS) is determined by the LARS score. A 7-point Likert scale was used to evaluate the satisfaction of the patients. Results: A total of 17 patients underwent resection by RE for rectal tumors. Of the 11 patients included in the study, 4 were female and 7 were male. The mean age was 66.09±15.04 years. The mean follow-up was 64.18±16.83 months. The mean tumor diameter was 3.1 cm (range: 0.9 to 7.2 cm). The mean distance of the tumor from the dentate line was 2.7 cm (range: 1.2 to 5.6 cm). No anastomotic leak was observed in any patient. One patient had an anastomotic stenosis and was treated with balloon dilatation. The median LARS score was 16 (range 0 to 32) and 64% of the patients had no LARS. Two patients had minor LARS and 2 patients had major LARS. The median Wexner score was 3.5 (range 0 to 14). The median Likert scale was 7 (range 5 to 7). It was found that 55% of the patients were extremely satisfied, 18% were satisfied, and 27% were slightly satisfied with their surgery. There were no dissatisfied patients. Conclusion: RE is a safe NOSE technique in laparoscopic double stapling anastomosis for rectal resection. There is a high level of long-term patient satisfaction with anus-sparing procedures via RE, even in the presence of various symptoms.

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Rectal eversion: safe and effective way to achieve low transaction in minimally invasive Ileal pouch-anal anastomosis surgery, short- and long-term outcomes

Cited by 3 publications

References 12 publications

Ileal Pouch-anal Anastomosis Complications and Pouch Failure

Ileal Pouch-anal Anastomosis Complications and Pouch Failure

Surgery for ulcerative colitis

Rectal Eversion as an Anus-sparing Technique in Laparoscopic Low Anterior Resection With Double Stapling Anastomosis: Long-term Functional Results

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