Review of current practice and outcomes following ileoanal pouch surgery: lessons learned from the Ileoanal Pouch Registry and the 2017 Ileoanal Pouch Report

Worley, Guy; Fearnhead, Nicola; Brown, S. R.; Acheson, Austin G; Lee, Matthew J.; Faiz, Omar; contributors, Ileoanal Pouch Registry

doi:10.1111/codi.14316

Cited by 34 publications

(31 citation statements)

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“…This is well below the threshold (10%; Figure 6B) most surveyed ANZ surgeons would consider that a TDI is in their patients' best interest, yet overall 80% of these ANZ surgeons would defunction an ileal pouch with a TDI. The self-reported UK pouch audit revealed a TDI rate of 77.3% [23] and in the Cleveland Clinic paper, they employed a TDI in 88.2% of their ileal pouches.…”

Section: Discussionmentioning

confidence: 99%

Geographical Variation in the Use of Diverting Loop Ileostomy in Australia and New Zealand Colorectal Surgeons

et al. 2021

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Section: Discussionmentioning

confidence: 99%

Geographical Variation in the Use of Diverting Loop Ileostomy in Australia and New Zealand Colorectal Surgeons

et al. 2021

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“…More than half undergo a major resection; 83% of these have a temporary stoma that is closed within 18 months in only 65% of patients . Approximately 6500 patients per year are diagnosed with ulcerative colitis in the United Kingdom , of whom 10–30% undergo surgery within 10 years after their diagnosis . IPAA is the most common restorative procedure after colectomy for ulcerative colitis in the UK .…”

Section: Introductionmentioning

confidence: 99%

Preoperative bowel stimulation prior to ileostomy closure to restore bowel function more quickly and improve postoperative outcomes: a systematic review

et al. 2019

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Aim Closure of a diverting ileostomy following restorative surgery is often associated with significant shortterm morbidity and variable long-term bowel function. The aim of this systematic review was to investigate if preoperative stimulation of the defunctioned bowel restores bowel function more quickly after ileostomy closure and improves postoperative outcomes when compared with standard preoperative care.Method MEDLINE, Embase, CENTRAL, Google Scholar and ClinicalTrials.gov were searched for studies evaluating preoperative bowel stimulation in patients with a temporary ileostomy after low anterior resection or ileal pouch-anal anastomosis, regardless of their design, publication type or language. Study selection, data extraction and study assessment were performed by one reviewer and verified by another. Study results were synthesized narratively. The GRADE approach was used to assess the quality of evidence.Results Eight studies involving a total of 267 participants were included. The studies had a moderate to high risk of bias and were of varying methodological quality. Preoperative stimulation of the defunctioned bowel reduced the time to postoperative restoration of bowel function and the length of hospital stay when compared with standard preoperative care. Other functional outcomes and postoperative complication rates were similar to those of standard preoperative care. The overall quality of evidence was very low.Conclusion Despite these promising early results, there is insufficient high-quality evidence to recommend routine implementation of preoperative bowel stimulation in clinical practice. Nevertheless, there is no evidence suggesting that the intervention worsens outcomes or is unsafe, paving the way for rigorous assessment of effectiveness, acceptability and cost-effectiveness within the context of well-designed clinical trials.

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“…Absolute contraindications to reconstructive surgery are sphincter incompetence, lower rectal cancer requiring a total excision of the anus-rectum and an acute setting, due to the high risk of pelvic bleeding, sepsis and injury to pelvic nerves [59,64]. Surgery needs to be performed in centers with surgeons who achieve an adequate volume of procedures in order to optimise long-term results and reduce the failure rate [58], which is 4.3% (95% CI 3.5-6.3) at 5 years [69,70]. Elderly patients can be selectively offered IPAA [71]; they should be offered the procedures, and potential complications and expected functional results should be clearly explained.…”

Section: Item 7 Restorative Proctocolectomy Is Undertaken As An Elective Procedures (El2) It Has Become the Standard Surgical Procedures mentioning

confidence: 99%

Inflammatory bowel disease position statement of the Italian Society of Colorectal Surgery (SICCR): ulcerative colitis

et al. 2020

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The Italian Society of Colorectal Surgery (SICCR) promoted the project reported here, which consists of a Position Statement of Italian colorectal surgeons to address the surgical aspects of ulcerative colitis management. Members of the society were invited to express their opinions on several items proposed by the writing committee, based on evidence available in the literature. The results are presented, focusing on relevant points. The present paper is not an alternative to available guidelines; rather, it offers a snapshot of the attitudes of SICCR surgeons about the surgical treatment of ulcerative colitis. The committee was able to identify some points of major disagreement and suggested strategies to improve the quality of available data and acceptance of guidelines.

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Review of current practice and outcomes following ileoanal pouch surgery: lessons learned from the Ileoanal Pouch Registry and the 2017 Ileoanal Pouch Report

Abstract: The IPR holds the largest voluntary repository of data on ileoanal pouch surgery. The second report from the IPR records marked refinements in surgical technique over time but also highlights wide variation in institutional caseload and outcome across the UK.

Cited by 34 publications

References 36 publications

Geographical Variation in the Use of Diverting Loop Ileostomy in Australia and New Zealand Colorectal Surgeons

Geographical Variation in the Use of Diverting Loop Ileostomy in Australia and New Zealand Colorectal Surgeons

Preoperative bowel stimulation prior to ileostomy closure to restore bowel function more quickly and improve postoperative outcomes: a systematic review

Inflammatory bowel disease position statement of the Italian Society of Colorectal Surgery (SICCR): ulcerative colitis

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