scholarly journals Recurrent Fistula between Ileal Pouch and Vagina—Successful Treatment with a Gracilis Muscle Flap

2009 ◽  
Vol 2009 ◽  
pp. 1-4 ◽  
Author(s):  
Feride Aydin ◽  
Claus Ferdinand Eisenberger ◽  
Andreas Raffel ◽  
Alexander Rehders ◽  
Stefan Benedikt Hosch ◽  
...  
Keyword(s):  
Familial Adenomatous Polyposis ◽  
Ileal Pouch ◽  
Muscle Flap ◽  
Gracilis Muscle ◽  
Adenomatous Polyposis ◽  
Muscle Flaps ◽  
Familial Adenomatous Polyposis Coli ◽  
Gracilis Muscle Flap ◽  
Recurrent Fistula ◽  
Anal Anastomosis

Fistulae between an ileal pouch and the vagina are an uncommon complication of ileal pouch-anal anastomosis following proctocolectomy and mucosectomy in patients with familial adenomatous polyposis coli. Several reports describe the successful use of muscle flaps to close recurrent pouch-vaginal-fistulae (PVF). However, series only contain small numbers and an optimal management has not yet been determined. We report the case of a 26-year old woman with a third recurrence of a PVF after proctocolectomy for treatment of familial adenomatous polyposis in October 2005. Because local approaches failed, definitive closure of the fistula was achieved by interposition of a gracilis muscle flap between the pouch-anal anastomosis and the vagina. The postoperative course was uneventful; the patient was discharged 7 days after surgery and remained free of recurrence and symptomatic complaints for 22 months now. The gracilis muscle flap proved to be an effective method in the treatment of recurrent PVF.

Use of a gracilis muscle flap to facilitate delayed ileal pouch-anal anastomosis

2000 ◽  
Vol 43 (11) ◽  
pp. 1628-1631 ◽  
Author(s):  
Robert C. Shamberger ◽  
Charles A. Hergrueter ◽  
Craig W. Lillehei
Keyword(s):  
Ileal Pouch ◽  
Muscle Flap ◽  
Gracilis Muscle ◽  
Ileal Pouch Anal Anastomosis ◽  
Gracilis Muscle Flap ◽  
Anal Anastomosis

scholarly journals Restorative Proctocolectomy: When to Propose and When to Avoid

2021 ◽  
Author(s):  
Marisa D. Santos
Keyword(s):  
Ulcerative Colitis ◽  
Familial Adenomatous Polyposis ◽  
Restorative Proctocolectomy ◽  
Ileal Pouch ◽  
Adenomatous Polyposis ◽  
Entire Colon ◽  
Anal Anastomosis ◽  
Colon And Rectum ◽  
Complex Surgery ◽  
Over Time

Restorative proctocolectomy with ileal pouch-anal anastomosis (RPC-IPAA) is a surgical procedure performed when excising the entire colon and rectum is need and reconstitution of the intestinal transit through an ileal pouch is made with anastomosis to the anus. It is mainly used to treat patients with familial adenomatous polyposis (FAP) and ulcerative colitis (UC). It is a complex surgery with potential complications, and the functional outcomes can be worse over time. So, it is essential to select the appropriate patient, proceed to a correct surgical technique, and know-how to deal with and solve the main ileal pouch complications. This chapter intends to be a reflection on this subject.

Restorative proctocolectomy and ileal pouch-anal anastomosis for familial adenomatous polyposis revisited

2006 ◽  
Vol 5 (3) ◽  
pp. 241-260 ◽  
Author(s):  
Alex Kartheuser ◽  
Pierre Stangherlin ◽  
Dimitri Brandt ◽  
Christophe Remue ◽  
Christine Sempoux
Keyword(s):  
Familial Adenomatous Polyposis ◽  
Restorative Proctocolectomy ◽  
Ileal Pouch ◽  
Ileal Pouch Anal Anastomosis ◽  
Adenomatous Polyposis ◽  
Anal Anastomosis

Patterns of Adenoma Recurrence in Familial Adenomatous Polyposis Patients after Ileal Pouch-Anal Anastomosis

2015 ◽  
Vol 32 (6) ◽  
pp. 421-425 ◽  
Author(s):  
Adam L. Goldstein ◽  
Revital Kariv ◽  
Joseph M. Klausner ◽  
Hagit Tulchinsky
Keyword(s):  
Familial Adenomatous Polyposis ◽  
Desmoid Tumor ◽  
Ileal Pouch ◽  
Medical Center ◽  
Colonic Polyps ◽  
Ileal Pouch Anal Anastomosis ◽  
Adenomatous Polyposis ◽  
Adenoma Recurrence ◽  
Duodenal Adenomas ◽  
Anal Anastomosis

Aim: This study aims at identifying the risk factors for the development of pre-cancerous pouch and/or cuff adenomas post ileal pouch anal anastomosis (IPAA) in familial adenomatous polyposis patients. Method: We retrospectively studied 59 patients operated at a single medical center during a 26-year period. Data on the timing and location of adenoma recurrence were recorded and possible correlations with patients' gender, age, presence of desmoid tumor, duodenal adenomas, type of anastomosis and number of operation stages were analyzed. Results: Thirty-five (59%) patients had at least one adenoma in either the cuff or the pouch, including 20 with isolated cuff adenomas, 4 with isolated pouch adenomas and 11 patients with adenomas in both the pouch and cuff. There was no significant correlation between gender, age at surgery, type of anastomosis, number of operative stages and the development of pouch or cuff adenomas. Desmoid tumor and pouch adenomas were significantly correlated with cuff adenomas formation. Duodenal adenomas were associated with pouch adenomas. There was some relationship between the development of cuff adenomas and the burden of colonic polyps, as well as the presence of duodenal adenomas. Conclusion: Adenomas in both the pouch and cuff commonly occur following IPAA, mandating lifelong annual endoscopic surveillance.

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