Stoma-less Ileal-Pouch-Anal-Anastomosis is Not Associated with Increased Anastomotic Leak Rate or Long-term Pouch Failure in Patients with Ulcerative Colitis

2022 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Elizabeth J. Olecki ◽  
Anthony P. Kronfli ◽  
Kelly A. Stahl ◽  
Steven King ◽  
Nina Razavi ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Anastomotic Leak ◽  
Ileal Pouch ◽  
Ileal Pouch Anal Anastomosis ◽  
Leak Rate ◽  
Anastomotic Leak Rate ◽  
Pouch Failure ◽  
Anal Anastomosis

Transanal Ileal Pouch-Anal Anastomosis for Ulcerative Colitis has Comparable Long-Term Functional Outcomes to Transabdominal Approach: A Multicentre Comparative Study

2019 ◽  
Vol 14 (6) ◽  
pp. 726-733 ◽  
Author(s):  
Pramodh Chandrasinghe ◽  
Michele Carvello ◽  
Karin Wasmann ◽  
Caterina Foppa ◽  
Pieter Tanis ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ulcerative Colitis ◽  
Functional Outcomes ◽  
Ileal Pouch ◽  
Cohort Analysis ◽  
Ileal Pouch Anal Anastomosis ◽  
Global Quality Of Life ◽  
Anal Anastomosis

Abstract Background The transanal approach to ileal pouch-anal anastomosis [Ta-IPAA] provides better access to the lower pelvis with lower short-term morbidity in ulcerative colitis [UC]. The aim of this study was to assess the long-term functional outcomes after Ta-IPAA vs transabdominal IPAA [Abd-IPAA] in UC. Methods A multicentre cohort analysis was performed between March 2002 and September 2017. Patient characteristics, surgical details and postoperative outcomes were compared. CGQL [Cleveland global quality of life] score at 12 months with a functioning pouch was considered the primary end point. Results A total of 374 patients [100 Ta-IPAA vs 274 Abd-IPAA] were included. Ta-IPAA demonstrated a comparable overall quality of life [CGQL score] to Abd-IPAA [0.75 ± 0.11 vs 0.71 ± 0.14; respectively, p = 0.1]. Quality of life [7.71 ± 1.17 vs 7.30 ± 1.46; p = 0.04] and energy-level items [7.16 ± 1.52 vs 6.66 ± 1.68; p = 0.03] were significantly better after Ta-IPAA, while the quality of health item was comparable [7.68 ± 1.26 vs 7.64 ± 1.44; p = 0.96]. Analysis excluding anastomotic leaks did not change the overall CGQL scores. Stool frequencies [>10/24 h: 22% vs 21%; p = 1.0] and the rate of a single episode of major incontinence during the following 12-month period [27% vs 26%; p = 0.89] were similar. The differences in 30-day morbidity rates [33% vs 41%; p = 0.2] and anastomotic leak rates were not significant [6% vs 13%; p = 0.09]. Conclusions This study provides evidence of comparable long-term functional outcome and quality of life after Ta-IPAA and Abd-IPAA for UC.

scholarly journals Long-term Risk of Cancer Following Ileal Pouch-anal Anastomosis for Ulcerative Colitis

2017 ◽  
Vol 12 (1) ◽  
pp. 57-62 ◽  
Author(s):  
Anders Mark-Christensen ◽  
Rune Erichsen ◽  
Søren Brandsborg ◽  
Jacob Rosenberg ◽  
Niels Qvist ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Ileal Pouch ◽  
Ileal Pouch Anal Anastomosis ◽  
Anal Anastomosis ◽  
Risk Of Cancer

scholarly journals P372 The long term course of patients undergoing ileal pouch-anal anastomosis for ulcerative colitis

2017 ◽  
Vol 11 (suppl_1) ◽  
pp. S267-S267
Author(s):  
F.S. Macaluso ◽  
F. Rossi ◽  
A. Orlando ◽  
C. Sapienza ◽  
E. Sinagra ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Ileal Pouch ◽  
Ileal Pouch Anal Anastomosis ◽  
Anal Anastomosis

scholarly journals Successful Long-Term Use of Infliximab in Refractory Pouchitis in an Adolescent

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Jessica Yeates ◽  
Mohsin Rashid
Keyword(s):  
Ulcerative Colitis ◽  
Adverse Effects ◽  
Maintenance Therapy ◽  
Ileal Pouch ◽  
Ileal Pouch Anal Anastomosis ◽  
Common Complication ◽  
Anal Anastomosis ◽  
Permanent Ileostomy ◽  
Inflammatory Drugs

Pouchitis is a common complication that develops after an ileal pouch-anal anastomosis after colectomy for ulcerative colitis. In some cases, pouchitis becomes chronic and refractory to conventional therapies including antibiotics, corticosteroids, immunomodulators, probiotics, and anti-inflammatory drugs. We report a case of an adolescent with chronic pouchitis who not only improved with infliximab therapy but remains in long-term remission with maintenance therapy without any adverse effects. Infliximab is a safe and effective therapy for refractory pouchitis and may obviate the need for pouch removal and a permanent ileostomy.

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