Ileal pouch-anal anastomosis (IPAA): functional outcome after postoperative pelvic sepsis

2005 ◽  
Vol 20 (6) ◽  
pp. 529-533 ◽  
Author(s):  
Helena Hallberg ◽  
Dagny Ståhlberg ◽  
Jan-Erik Åkerlund
Keyword(s):  
Functional Outcome ◽  
Ileal Pouch ◽  
Ileal Pouch Anal Anastomosis ◽  
Pelvic Sepsis ◽  
Anal Anastomosis

Management, Functional Outcomes and Quality of Life After Development of Pelvic Sepsis in Patients Undergoing Re-Do Ileal Pouch Anal Anastomosis

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Eren Esen ◽  
Michael J. Grieco ◽  
Arman Erkan ◽  
Erman Aytac ◽  
Alton G. Sutter ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Functional Outcomes ◽  
Ileal Pouch ◽  
Ileal Pouch Anal Anastomosis ◽  
Pelvic Sepsis ◽  
Anal Anastomosis

Postoperative Steroid Taper Is Associated With Pelvic Sepsis After Ileal Pouch-anal Anastomosis

2018 ◽  
Vol 25 (8) ◽  
pp. 1383-1389 ◽  
Author(s):  
Kaitlin A Ritter ◽  
John P Burke ◽  
Luca Stocchi ◽  
Alexandra Aiello ◽  
Stefan Holubar ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Multivariate Analysis ◽  
Ileal Pouch ◽  
Ileal Pouch Anal Anastomosis ◽  
Pelvic Sepsis ◽  
Oral Steroid ◽  
Total Proctocolectomy ◽  
Steroid Use ◽  
Anal Anastomosis ◽  
Inflammatory Bowel

AbstractObjectiveWe hypothesized that postoperative oral steroid taper after ileal pouch-anal anastomosis for inflammatory bowel disease would not be associated with pelvic septic complications.BackgroundRecent data has emphasized the possible association between biologic medication use and pelvic sepsis following ileal pouch-anal anastomosis. Limited contemporary data exist examining the effects of steroid use on these complications.MethodsConsecutive patients undergoing ileal pouch-anal anastomosis for inflammatory bowel disease at a single institution from January 2009 to December 2013 were included. Factors associated with anastomotic leak and pelvic sepsis were assessed using univariate and multivariate analysis.ResultsA total of 686 patients were included (mean age 39.5 years, 59% males). Postoperative oral steroid taper was associated with both anastomotic leak and pelvic sepsis on univariate analysis. Stress dose intravenous steroid use was not associated with complications. Multivariate analysis indicated total proctocolectomy (odds ratio [OR] 2.2; confidence interval [CI] 1.01–4.7, P = 0.047), and postoperative oral steroid taper (OR 2.3; CI 1.06–5.1; P = 0.035) as independent factors significantly associated with pelvic sepsis.ConclusionsProlonged postoperative oral steroid taper after ileal pouch-anal anastomosis should be avoided. If preoperative steroid weaning is not possible before a planned total proctocolectomy and ileal pouch-anal anastomosis, patients should undergo an initial total abdominal colectomy.

scholarly journals Prospective, Age-Related Analysis of Surgical Results, Functional Outcome, and Quality of Life After Ileal Pouch-Anal Anastomosis

2003 ◽  
Vol 238 (2) ◽  
pp. 221-228 ◽  
Author(s):  
Conor P. Delaney ◽  
Victor W. Fazio ◽  
Feza H. Remzi ◽  
Jeff Hammel ◽  
James M. Church ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Functional Outcome ◽  
Ileal Pouch ◽  
Ileal Pouch Anal Anastomosis ◽  
Surgical Results ◽  
Age Related ◽  
Anal Anastomosis

Can a Meta-Analysis Answer the Question: Is Mucosectomy and Handsewn or Double-Stapled Anastomosis Better in Ileal Pouch-Anal Anastomosis?

2006 ◽  
Vol 72 (10) ◽  
pp. 912-916 ◽  
Author(s):  
Stefanie J. Schluender ◽  
Ling Mei ◽  
Huiying Yang ◽  
Phillip R. Fleshner
Keyword(s):  
Functional Outcome ◽  
Statistical Power ◽  
Randomized Trials ◽  
Ileal Pouch ◽  
Meta Analysis ◽  
Ileal Pouch Anal Anastomosis ◽  
Postoperative Function ◽  
Significant Difference ◽  
Anal Anastomosis ◽  
Patient Groups

Although ileal pouch-anal anastomosis (IPAA) is the procedure of choice for polyposis and ulcerative colitis with medically refractory disease or dysplasia, controversy exists concerning whether mucosal preservation with double-stapled (DS) IPAA is superior to mucosectomy and handsewn (HS) IPAA anastomosis for postoperative function. Prospective studies have shown no statistically significant differences. The use of meta-analysis can strengthen statistical power by combining the data from related studies. A meta-analysis was performed to determine whether there was a significant difference in functional and manometric outcome between HS-IPAA and DS-IPAA. Prospective, randomized studies were identified using a literature search. Functional outcome variables included number of normal continence, minor incontinence, nocturnal evacuation, the ability to discriminate flatus from stool, and antidiarrheal medication. Manometric outcomes included postoperative resting and squeeze anal pressures. Four prospective, randomized trials were identified. Of the 184 total patients, the HS-IPAA group included 86 patients (48 men and 38 women) and the DS-IPAA group included 98 patients (49 men and 49 women). There were no significant differences in functional outcome between HS-IPAA and DS-IPAA. In addition, there was no significant difference in sphincter resting and squeeze pressures between the two patient groups. This meta-analysis demonstrates that DS-IPAA offers no advantage in functional or manometric outcome when compared with HS-IPAA.

Rare complication after ileal pouch-anal anastomosis: Bilateral ureteral obstruction due to pelvic sepsis and retroperitoneal fibrosis

2012 ◽  
Vol 16 (2) ◽  
pp. 81-83 ◽  
Author(s):  
Leonardo Maciel da Fonseca ◽  
Cristiane de Souza Bechara ◽  
Conrado Leonel Menezes ◽  
Carlos Eduardo Corradi Fonseca ◽  
Rodrigo Gomes da Silva
Keyword(s):  
Ureteral Obstruction ◽  
Ileal Pouch ◽  
Retroperitoneal Fibrosis ◽  
Rare Complication ◽  
Ileal Pouch Anal Anastomosis ◽  
Pelvic Sepsis ◽  
Anal Anastomosis

Functional Outcome, Quality of Life, and Complications After Ileal Pouch-Anal Anastomosis in Selected Septuagenarians

2002 ◽  
Vol 45 (7) ◽  
pp. 890-894 ◽  
Author(s):  
Conor P. Delaney ◽  
Babak Dadvand ◽  
Feza H. Remzi ◽  
James M. Church ◽  
Victor W. Fazio
Keyword(s):  
Quality Of Life ◽  
Functional Outcome ◽  
Ileal Pouch ◽  
Ileal Pouch Anal Anastomosis ◽  
Outcome Quality ◽  
Anal Anastomosis

Outcome of Ileal Pouch-anal Anastomosis in Patients With Indeterminate Colitis: A Systematic Review and Meta-analysis

2020 ◽  
Vol 14 (7) ◽  
pp. 1010-1020
Author(s):  
Sameh Hany Emile ◽  
Hayim Gilshtein ◽  
Steven D Wexner
Keyword(s):  
Systematic Review ◽  
Crohn’S Disease ◽  
Ileal Pouch ◽  
Meta Analysis ◽  
Ileal Pouch Anal Anastomosis ◽  
Pelvic Sepsis ◽  
Indeterminate Colitis ◽  
Weighted Mean ◽  
Pouch Failure ◽  
Anal Anastomosis

Abstract Background Indeterminate colitis [IC] is type of inflammatory bowel disease that exhibits features of both ulcerative colitis [UC] and Crohn’s disease [CD]. The present meta-analysis aimed to assess the outcomes of ileal pouch-anal anastomosis [IPAA] in patients with IC in comparison with patients with UC. Methods A PRISMA-compliant systematic review of the outcome of IPAA in patients with IC was conducted. Electronic databases were searched, and full-text articles were reviewed to extract essential data. Main outcome measures were pouch failure and pouch-related complications. Results A total of 17 studies were included in this meta-analysis. There were 1057 patients with IC and 6511 patients with UC. The weighted mean pouch failure rate in patients with IC was 7.5 (95% confidence interval [CI]: 4.8–10.2) and the weighted mean complication rate was 67 [95% CI: 53.5–80.5]. As compared with patients with UC, patients with IC had significantly higher odds of developing complications after IPAA (odds ratio [OR]: 2.6, p <0.001): pouch fistula [OR:4.98, p <0.001], pelvic sepsis [OR:3.98, p =0.002], pelvic or cuff abscess [OR: 4.5, p <0.001], perineal complications [OR: 5.13, p <0.001], and ultimate diagnosis of CD [OR: 2.57, p <0.001]. Patients with IC and UC had similar odds of pouch failure, pouchitis, anastomotic leak, stricture, and small bowel obstruction. Conclusions Patients with IC had similar pouch failure rates, yet higher overall complication rates than patients with UC. Complications that tend to be higher after IPAA for patients with IC include pouch fistula, pelvic sepsis, abscess, perineal complications, and ultimate diagnosis of Crohn’s disease.

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