Role of glucagon-like peptide (GLP)-2 and glicentin in an adaptive response after total proctocolectomy with ileal J-pouch anal anastomosis

Minimally invasive surgery continues to evolve. Recent innovations have included single-incision access, robotic technology, and natural orifice dissection and/or specimen extraction. Many argue that there is minimal patient benefit to these advanced techniques. We report 39 patients undergoing laparoscopic ileal J-pouch anal anastomosis surgery, 17 of whom did not have a separate specimen extraction incision (Group 1). The specimen for this group was extracted through the circular incision made for the ileostomy; the pouch was constructed extracorporeally and returned to the abdomen through the stoma site. For the remaining 22 patients, a suprapubic Pfannenstiel incision was made (Group 2). No hand-assistance was used for either group. Group 1 showed a 45-minute reduction in operative time, a 1-day reduction in hospital stay, and a reduction in complications. Although these differences are modest, it shows that minimally invasive surgery is an evolving process. Small modifications may translate into significant advantages.

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Laparoscopic rectopexy for recurrent volvulus of J pouch after total proctocolectomy and ileal pouch anal anastomosis

Surgical Practice ◽

10.1111/1744-1633.12072 ◽

2015 ◽

Vol 19 (3) ◽

pp. 133-136 ◽

Cited By ~ 1

Author(s):

Suet-Ying Lee ◽

Ka-Lung Fok ◽

Hester Yui-Shan Cheung ◽

Chung-Ngai Tang

Keyword(s):

Ileal Pouch ◽

Ileal Pouch Anal Anastomosis ◽

Total Proctocolectomy ◽

Laparoscopic Rectopexy ◽

Anal Anastomosis ◽

J Pouch

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Role of luminal nutrients and endogenous GLP-2 in intestinal adaptation to mid-small bowel resection

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.00293.2002 ◽

2003 ◽

Vol 284 (4) ◽

pp. G670-G682 ◽

Cited By ~ 60

Author(s):

Elizabeth M. Dahly ◽

Melanie B. Gillingham ◽

Ziwen Guo ◽

Sangita G. Murali ◽

David W. Nelson ◽

...

Keyword(s):

Small Bowel ◽

Adaptive Response ◽

Bowel Resection ◽

Intestinal Adaptation ◽

Small Bowel Resection ◽

Oral Feeding ◽

Enterocyte Proliferation ◽

Glucagon Like Peptide ◽

Mucosal Growth

To elucidate the role of luminal nutrients and glucagon-like peptide-2 (GLP-2) in intestinal adaptation, rats were subjected to 70% midjejunoileal resection or ileal transection and were maintained with total parenteral nutrition (TPN) or oral feeding. TPN rats showed small bowel mucosal hyperplasia at 8 h through 7 days after resection, demonstrating that exogenous luminal nutrients are not essential for resection-induced adaptation when residual ileum and colon are present. Increased enterocyte proliferation was a stronger determinant of resection-induced mucosal growth in orally fed animals, whereas decreased apoptosis showed a greater effect in TPN animals. Resection induced significant transient increases in plasma bioactive GLP-2 during TPN, whereas resection induced sustained increases in plasma GLP-2 during oral feeding. Resection-induced adaptive growth in TPN and orally fed rats was associated with a significant positive correlation between increases in plasma bioactive GLP-2 and proglucagon mRNA expression in the colon of TPN rats and ileum of orally fed rats. These data support a significant role for endogenous GLP-2 in the adaptive response to mid-small bowel resection in both TPN and orally fed rats.

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Comparison of Reduced-port and Conventional Laparoscopic Total Proctocolectomy with Ileal J-pouch–anal Anastomosis

The American Surgeon ◽

10.1177/000313481508100211 ◽

2015 ◽

Vol 81 (2) ◽

pp. 70-72

Author(s):

Yasuhiro Inoue ◽

Junichiro Hiro ◽

Aya Kawamoto ◽

Yoshinaga Okugawa ◽

Yoshiki Okita ◽

...

Keyword(s):

Total Proctocolectomy ◽

Conventional Laparoscopic ◽

Anal Anastomosis ◽

J Pouch ◽

Reduced Port

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Reduced port versus conventional laparoscopic total proctocolectomy and ileal J pouch-anal anastomosis

Surgical Endoscopy ◽

10.1007/s00464-012-2372-7 ◽

2012 ◽

Vol 26 (12) ◽

pp. 3495-3499 ◽

Cited By ~ 14

Author(s):

Meagan M. Costedio ◽

Erman Aytac ◽

Emre Gorgun ◽

Ravi P. Kiran ◽

Feza H. Remzi

Keyword(s):

Total Proctocolectomy ◽

Conventional Laparoscopic ◽

Anal Anastomosis ◽

J Pouch ◽

Reduced Port

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Cap polyposis treated with laparoscopic-assisted total proctocolectomy and ileal J-pouch anal anastomosis: a case report

Surgical Case Reports ◽

10.1186/s40792-021-01214-7 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Tomohiro Minagawa ◽

Hiroki Ikeuchi ◽

Kurando Kusunoki ◽

Ryuichi Kuwahara ◽

Yuki Horio ◽

...

Keyword(s):

Antimicrobial Treatment ◽

Total Proctocolectomy ◽

Aminosalicylic Acid ◽

Short Period ◽

Anal Anastomosis ◽

J Pouch ◽

Cap Polyposis ◽

Laparoscopic Assisted ◽

Bloody Stools

Abstract Background Cap polyposis (CP) is extremely rare in Japan, and there is no established cure. We report a case in which CP was improved by surgical treatment. Case presentation A 48-year-old man was investigated at a local hospital because of diarrhea and bloody stools in 2018. The patient was treated with metronidazole for suspected amoebic dysentery, but his symptoms did not improve. Subsequent close examination revealed possible CP, but treatment with 5-aminosalicylic acid and a steroid enema had no effect. The patient was then referred to our hospital. The bloody stools, diarrhea, and abdominal pain worsened despite medical treatment, so laparoscopic-assisted total proctocolectomy and ileal J-pouch anal anastomosis with ileostomy were performed. CP has no known cause or established treatment, but Helicobacter pylori (HP) infection has been reported in many CP cases in Japan, and HP eradication is often successful. This patient was HP-negative and did not improve with antimicrobial treatment, but the symptoms improved after surgery. Conclusions Even after surgery, CP recurrence reportedly occurs within a short period in many cases. However, our patient has had no signs of CP recurrence during 1 year of follow-up.

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