Handsewn Versus Stapled IPAA in Redo Setting: Indications, Patient Characteristics, Operative, Functional, and Quality-of-Life Outcomes

Esen, Eren; Erkan, Arman; Aytaç, Erman; Esterow, Joanna; Grieco, Michael J.; Kirat, Hasan T.; Remzi, Feza H.

doi:10.1097/dcr.0000000000001963

Cited by 5 publications

(4 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…If adequate blood perfusion cannot be achieved by conventional methods, indocyanine green fluorescence angiography may be used [9]. A stapled anastomosis is preferred when there is enough room in the anal canal to place a stapler; otherwise mucosectomy and handsewn anastomosis is performed [10]. The procedure is completed with a new diverting loop ileostomy.…”

Section: Operative Techniquementioning

confidence: 99%

Operative, long‐term and quality of life outcomes after salvage of failed re‐do ileal pouch anal anastomosis

et al. 2022

Self Cite

View full text Add to dashboard Cite

Aim Approximately 20%–40% of the patients with re‐do ileal pouch anal anastomosis (IPAA) experience pouch failure. Salvage surgery can be attempted in this patient group with severe aversion to permanent ileostomy. The literature regarding secondary IPAA revision after re‐do IPAA failure is scarce. Methods All patients who underwent a secondary IPAA revision after re‐do IPAA failure between September 2016 and July 2021 in a single centre were included. Short‐ and long‐term outcomes and quality of life in this patient group are reported. Results Ten patients who had secondary IPAA revision for re‐do IPAA failure were included. All patients had ulcerative colitis. Nine of these patients had pelvic sepsis and one patient had a mechanical issue. Mucosectomy and handsewn anastomosis was performed in nine patients. The existing pouch was salvaged in six patients and four patients had pouch excision and re‐creation. Two patients had postoperative pelvic sepsis. Pouch retention rate was 78% in a median of 28 months. None of the patients had short‐gut syndrome. The procedure was associated with good quality of life (median Cleveland Global Quality of Life Index 0.8). All patients would undergo the same surgery if needed. Conclusion Secondary IPAA revision after a failed re‐do IPAA can be an option in patients with severe aversion to permanent ileostomy if re‐do IPAA fails and it is associated with good outcomes. This patient group should be carefully evaluated and referred to specialized centres if required.

show abstract

Section: Operative Techniquementioning

confidence: 99%

Operative, long‐term and quality of life outcomes after salvage of failed re‐do ileal pouch anal anastomosis

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Redo Pouch Indications and Techniquementioning

confidence: 99%

“…In a single-center series 75% of the patients required mucosectomy and handsewn anastomosis during redo IPAA, there was no difference in morbidity, QOL, and function when handsewn was compared with stapled anastomosis in the redo setting. 27 A contrast enema study is performed after 3 months to assess anastomotic integrity. The diverting loop ileostomy is only reversed if there is no sign of radiological leak/sinus.…”

Section: Redo Pouch Indications and Techniquementioning

confidence: 99%

Pelvic Pouch Failure: Treatment Options

Lynn

Brandstetter

Schwartzberg

2022

Clin Colon Rectal Surg

View full text Add to dashboard Cite

Up to 30% of patients with ulcerative colitis (UC) will require surgical management of their disease during their lifetime. An ileal pouch-anal anastomosis (IPAA) is the gold standard of care, giving patients the ability to be free from UC's bowel disease and avoid a permanent ostomy. Despite surgical advancements, a minority of patients will still experience pouch failure which can be debilitating and often require further surgical interventions. Signs and symptoms of pouch failure should be addressed with the appropriate workup and treatment plans formulated according with the patient's wishes. This article will discuss the identification, workup, and treatment options for pouch failure after IPAA.

show abstract

“…4,5,6 In colorectal surgery, loop ileostomies are commonly used to treat distal enteric illness and anastomoses. 7 A diverting loop ileostomy effectively reduces the effects of leakage through sutures and is thought to lower the occurrence of anastomotic problems by certain investigators. However, after reversing an ileostomy, there is a 0.1-4% death risk.…”

Section: Introductionmentioning

confidence: 99%

The Comparison of Hand Sewn and Stapled Anastomoses

Hussain

Jabbar

Ahmed

et al. 2022

PAFMJ

View full text Add to dashboard Cite

Objective: To compare hand-sewn and stapled sutures and the influence of intestinal excision on postoperative complications. Study Design: Retrospective comparative study. Place and Duration of Study: General Surgery Department of CMH Peshawar, from Jan 2020 to Jan 2021. Methodology: Once receiving consent, all individuals hospitalized in the medical facility for ileostomy closure were included in our investigation. In a questionnaire, postoperative complications were documented. Result: This study involved a total of 60 subjects. Individuals were scheduled for surgery after receiving clearances and a loopogram distally. Thirty patients had their wounds hand-sewn shut, while 30 others had their wounds stapled shut. The mean operating time for the hand-sewn method was 2.46 ± 0.29 hours, compared to 1.86 ± 0.17 hours mean for the stapled method. In both categories, the anastomotic leak was comparable. Thirty patients in the hand-sewn group took a mean of 2.42 ± 0.25 days to return bowel sounds after surgery, whereas it took 1.83 ± 0.20 days to return bowel sounds. Conclusion: The stapler method greatly decreases the duration of surgery, promotes rapid recovery, and has a lower fatality rate. Stapling is a simple procedure that can be performed in inaccessible locations, such as a low colorectal anastomosis. In elective gastrointestinal procedures, stapler anastomosis can be utilized safely and successfully.

show abstract

Handsewn Versus Stapled IPAA in Redo Setting: Indications, Patient Characteristics, Operative, Functional, and Quality-of-Life Outcomes

Cited by 5 publications

References 18 publications

Operative, long‐term and quality of life outcomes after salvage of failed re‐do ileal pouch anal anastomosis

Operative, long‐term and quality of life outcomes after salvage of failed re‐do ileal pouch anal anastomosis

Pelvic Pouch Failure: Treatment Options

The Comparison of Hand Sewn and Stapled Anastomoses

Contact Info

Product

Resources

About