Surgical treatment and role of dynamic defecography in impaired evacuation after ileal pouch-anal anastomosis

Silvis, R.; Delemarre, J. B. V. M.; Gooszen, Hein G.

doi:10.1007/bf02055687

Cited by 6 publications

(3 citation statements)

References 9 publications

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“…Dynamic defecographic studies have shown that even in the most efficiently functioning ileal pouch, residual volume remains following evacuation [30,31]. Although the resultant stasis has been purported to play a role in the pathogenesis of ileal pouch inflammation or pouchitis [32], efforts to directly associate stasis as an initiating factor in the inflammatory response has been difficult.…”

Section: Discussionmentioning

confidence: 99%

Stasis Predisposes Ileal Pouch Inflammation in a Rat Model of Ileal Pouch-Anal Anastomosis

Stucchi

Shebani

Reed

et al. 2010

Journal of Surgical Research

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Section: Discussionmentioning

confidence: 99%

Stasis Predisposes Ileal Pouch Inflammation in a Rat Model of Ileal Pouch-Anal Anastomosis

Stucchi

Shebani

Reed

et al. 2010

Journal of Surgical Research

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“…Silvis et al . performed a transabdominal strictureplasty using a linear stapler to shorten the efferent limb . Similarly, Klingler et al .…”

Section: Discussionmentioning

confidence: 99%

Endoscopy‐assisted transanal repair of afferent limb obstruction and long efferent limb with ileopexy after ileal J‐pouch‐anal anastomosis

Araki

Okita

Kawamura

et al. 2016

Asian J Endoscop Surgery

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Afferent limb obstruction can be a persistent complication after restorative proctocolectomy with ileal pouch-anal anastomosis. We present a case of afferent limb obstruction complicated by a long efferent limb of the ileal pouch that we successfully treated with side-to-side anastomosis of the afferent and efferent limbs. The procedure involved using a transanal endoscopic stapling device assisted by transanal endoscopy with a thin intestinal video endoscope. This allowed reliable, safe visualization of the lesion from the tight pouch-anal anastomosis and facilitated repair with an endoscopic stapling device. Because the technique was performed without enterotomy, it reduced the risks of contamination and leakage from transabdominal small bowel anastomosis. Laparotomy view also prevented of injury to the pouch itself and entrapment of the mesentery of the afferent and efferent limbs of the pouch between the stapler anvils.

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“…Dynamic defecography studies have shown that even in the most efficiently functioning ileal pouch, residual volume remains following evacuation [30], although the resultant stasis has been purported to play a role in the pathogenesis of ileal pouch inflammation or pouchitis [31].…”

Section: Pathophysiologymentioning

confidence: 99%

Surgical Prophylaxis of Pouchitis in Ulcerative Colitis

et al. 2010

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Ileal pouch-anal anastomosis (IPAA) is now the procedure of choice for most patients requiring proctocolectomy for ulcerative colitis. The J-shaped pouch, usually 15-20 cm in length, is easiest to construct and has functional outcomes identical to those of the more complex designs. IPAA is a complex procedure, and complications occur frequently. Despite the significant improvements this surgical advance has made on the quality of life in these patients, inflammation of the surgically created ileal pouch or pouchitis remains a major late postoperative complication that can often overshadow the benefits of this otherwise curative operation. Several inflammatory and noninflammatory complications can occur after IPAA. Pouchitis is the most common, occurring in ≈50% of patients. Whereas acute pouchitis can be treated rapidly and successfully in the majority of patients, refractory and chronic pouchitis remain therapeutic challenges to patients and physicians. The problem is believed to be caused by stasis of feces in the pouch with overgrowth of aerobic and anaerobic organisms. The size of the pouch has a significant influence on the incidence of pouchitis: a smaller pouch usually empties better than a larger pouch and so may be less susceptible to pouchitis.

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Surgical treatment and role of dynamic defecography in impaired evacuation after ileal pouch-anal anastomosis

Abstract: Dynamic defecography is indispensable for tailoring surgical treatment. Effective transabdominal shortening of the efferent limb can be performed with the aid of a linear stapler.

Cited by 6 publications

References 9 publications

Stasis Predisposes Ileal Pouch Inflammation in a Rat Model of Ileal Pouch-Anal Anastomosis

Stasis Predisposes Ileal Pouch Inflammation in a Rat Model of Ileal Pouch-Anal Anastomosis

Endoscopy‐assisted transanal repair of afferent limb obstruction and long efferent limb with ileopexy after ileal J‐pouch‐anal anastomosis

Surgical Prophylaxis of Pouchitis in Ulcerative Colitis

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