Clostridium difficileinfection after restorative proctocolectomy and ileal pouch anal anastomosis for ulcerative colitis

2016 ◽  
Vol 18 (5) ◽  
pp. O154-O157 ◽  
Author(s):  
M. L. Martinez Ugarte ◽  
A. L. Lightner ◽  
D. Colibaseanu ◽  
S. Khanna ◽  
D. S. Pardi ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Restorative Proctocolectomy ◽  
Ileal Pouch ◽  
Ileal Pouch Anal Anastomosis ◽  
Anal Anastomosis

Risk Factors for Diseases of Ileal Pouch–Anal Anastomosis After Restorative Proctocolectomy for Ulcerative Colitis

2006 ◽  
Vol 4 (1) ◽  
pp. 81-89 ◽  
Author(s):  
Bo Shen ◽  
Victor W. Fazio ◽  
Feza H. Remzi ◽  
Aaron Brzezinski ◽  
Ana E. Bennett ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ulcerative Colitis ◽  
Restorative Proctocolectomy ◽  
Ileal Pouch ◽  
Ileal Pouch Anal Anastomosis ◽  
Anal Anastomosis

scholarly journals RESTORATIVE PROCTOCOLECTOMY WITH ILEAL POUCH-ANAL ANASTOMOSIS FOR SEVERE ULCERATIVE COLITIS IN RURAL NEPAL

2003 ◽  
Vol 42 (150) ◽  
pp. 360-363
Author(s):  
K P Ghimire ◽  
Kenneth Walker
Keyword(s):  
Ulcerative Colitis ◽  
Medical Therapy ◽  
Restorative Proctocolectomy ◽  
Ileal Pouch ◽  
Elective Surgery ◽  
Appropriate Technology ◽  
Ileal Pouch Anal Anastomosis ◽  
Bowel Habit ◽  
Anal Anastomosis ◽  
Rural Nepal

For most patients with ulcerative colitis (UC) requiring surgery, restorative proctocolectomy (RP) may bethe operation of choice. By using an ileal pouch-anal anastomosis, it offers a curative operation with no needfor a permanent ileostomy. We present a 16 year-old boy from a remote village with chronic UC whichfailed to respond satisfactorily to maximal medical therapy. We opted for elective surgery because he wasunlikely to comply with long-term medical therapy and surveillance, nor to survive if he came to emergencysurgery in our setting. RP was performed and he recovered well. His bowel habit was better than the 5 or 6motions per day that is typical following this procedure. Where the expertise is available, the operation canbe performed and any complications managed, using only the basic facilities available in most districthospitals. We present this case as an example of the “one-hit medicine” approach that is often required inour context. We suggest that RP may occasionally be indicated for UC in rural Nepal, where the alternativescarry relatively greater disadvantages.Key Words: Restorative proctocolectomy, ileal pouch-anal anastomosis,ulcerative colitis, appropriate technology.

scholarly journals Association of ileocolic pedicle division with postoperative complications after restorative proctocolectomy and ileal pouch-anal anastomosis for ulcerative colitis

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Emmanouil Tzatzarakis ◽  
Florian Herrle ◽  
Wolfgang Reindl ◽  
Nora Altmayer ◽  
Dominik Minas ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Postoperative Complications ◽  
Restorative Proctocolectomy ◽  
Ileal Pouch ◽  
Statistical Significance ◽  
Ileal Pouch Anal Anastomosis ◽  
Abscess Formation ◽  
Entire Study ◽  
Anastomotic Strictures ◽  
Anal Anastomosis

Abstract Background When performing a restorative proctocolectomy (RPC) with an ileal pouch-anal anastomosis (IPAA), it is common practice to divide the ileocolic artery (ICA) if the patient has a tumor or dysplasia, or in order to gain sufficient length to secure a tension-free anastomosis. However, it is unclear whether there is an association between division of the ICA and the rate of postoperative complications. Methods We retrospectively analysed all patients with ulcerative colitis who underwent RPC and IPAA in our department between January 2010 and December 2016. These were divided in two groups, with regard to the ICA being preserved (PRE group) or divided (DIV group). Complications such as stenosis or leakage of the IPAA, perianal fistulas, abscess formation within the lesser pelvis and pouchitis were analysed and compared between both groups. Results We identified 130 patients meeting the study inclusion criteria, 49 patients in the PRE and 81 patients in the DIV group. No statistical significance was observed in IPAA leakages (p = 0.71), anastomotic strictures (p = 0.33), fistulas (p = 0.19) and pouchitis (p = 0.72). Abscess formation frequency was similar in both groups (p > 0.99). Moreover, short-term (p = 0.53) and long-term complications (p = 0.11) were similar in both groups. A higher conversion rate was observed in obese (p = 0.006) and male (p = 0.02) patients. Within the entire study population, fistulas and IPAA leakages were associated with a higher rate of anastomotic strictures (p = 0.008 and p = 0.02 respectively). Conclusion Our data suggest similar IPAA related complications after either division or preservation of the ICA. Further trials are required in order to examine the trends observed in this study.

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