Ileal pouch–anal anastomosis

McGuire, Barry B.; Brannigan, A. E.; O'Connell, P. R.

doi:10.1002/bjs.5866

Cited by 102 publications

(53 citation statements)

References 137 publications

(158 reference statements)

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“…In CD of the pouch, pelvic magnetic resonance imaging may reveal sinus tracts, fi stulae, and leaks and abscesses outside the cuff ( 343 ). Pouch excision, or revision in expert hands ( 344 ), is required as a result of intractable pouch complications in fewer than 5 % of patients in most series.…”

Section: Recommendations For the Management Of Pouchitismentioning

confidence: 99%

Ulcerative Colitis Practice Guidelines in Adults: American College of Gastroenterology, Practice Parameters Committee

Kornbluth

Sachar

2010

American Journal of Gastroenterology

1,142

977

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Guidelines for clinical practice are aimed to indicate preferred approaches to medical problems as established by scientifi cally valid research. Double-blind placebo controlled studies are preferable, but compassionate-use reports and expert review articles are used in a thorough review of the literature conducted through Medline with the National Library of Medicine. When only data that will not withstand objective scrutiny are available, a recommendation is identifi ed as a consensus of experts. Guidelines are applicable to all physicians who address the subject regardless of specialty training or interests and are aimed to indicate the preferable but not necessarily the only acceptable approach to a specifi c problem. Guidelines are intended to be fl exible and must be distinguished from standards of care, which are infl exible and rarely violated. Given the wide range of specifi cs in any healthcare problem, the physician must always choose the course best suited to the individual patient and the variables in existence at the moment of decision. Guidelines are developed under the auspices of the American College of Gastroenterology and its Practice Parameters Committee and approved by the board of trustees. Each has been intensely reviewed and revised by the Committee, other experts in the fi eld, physicians who will use them, and specialists in the science of decision analysis. The recommendations of each guideline are therefore considered valid at the time of composition based on the data available. New developments in medical research and practice pertinent to each guideline will be reviewed at a time established and indicated at publication to assure continued validity. The recommendations made are based on the level of evidence found. Grade A recommendations imply that there is consistent level 1 evidence (randomized controlled trials), grade B indicates that the evidence would be level 2 or 3, which are cohort studies or case -control studies. Grade C recommendations are based on level 4 studies, meaning case series or poor-quality cohort studies, and grade D recommendations are based on level 5 evidence, meaning expert opinion.

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Section: Recommendations For the Management Of Pouchitismentioning

confidence: 99%

Ulcerative Colitis Practice Guidelines in Adults: American College of Gastroenterology, Practice Parameters Committee

Kornbluth

Sachar

2010

American Journal of Gastroenterology

1,142

977

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“…Proktokolektomi med anlegging av bekkenreservoar av tynntarm og anastomose til analkanalen (IPAA) er blitt førstevalg når det gjelder kirurgisk behandling av ulcerøs kolitt hos pasienter som ikke responderer på medisinsk behandling eller ved malignitetsutvikling (1)(2)(3)(4)(5). Prosedyren er teknisk krevende, og det er betydelig risiko for postoperative komplikasjoner (6).…”

Section: Sammendragunclassified

“…Pouchitt, definert som økende avføringsfre-kvens, endret avføringskonsistens, blodig avføring og smerter av varighet i over to døgn, sammenholdt med funn ved reservoarskopi, ble sett hos 30 % av pasientene. I andre undersøkelser har det vaert pouchitt hos opptil 60 % av pasientene under en oppfølgingstid på opp mot 20 år (1,4,8,9). År-saken til at vi har hatt mindre pouchitt kan vaere kortere observasjonstid (median 109 md.).…”

Section: Diskusjonunclassified

“…I vår studie er det heller ikke brukt skå-ringssystemer eller kriteriebaserte skjemaer for å sette diagnosen, og man vet at symptomatiske kriterier for pouchitt kan vaere unøyaktige (10). Andre komplikasjoner forventes hos 19-30 % av pasientene etter bekkenreservoarkirurgi (4,6,11,12). I vårt materiale gjaldt dette ni pasienter (21 %), og fem av disse måtte opereres på nytt.…”

Section: Diskusjonunclassified

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Bekkenreservoarkirurgi

Stornes¹,

Skreden²,

Sollie³

et al. 2010

Tidsskriftet

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“…Most patients with an IPAA are satisfied with the pouch function. [1][2][3] However, in some patients the function is marred by a high frequency of pouch emptying, urgency and/or incontinence. About 10% of patients with an IPAA end up with a failure of the pouch, leading to excision of the pouch or permanent diversion with an abdominal ileostomy, or conversion of the pouch to a continent ileostomy.…”

Section: Introductionmentioning

confidence: 99%

Sexual function after failed ileal pouch-anal anastomosis

Bengtsson¹,

Lindholm²,

Nordgren³

et al. 2011

Journal of Crohn's and Colitis

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Background and Aims: Failure of ileal pouch-anal anastomosis (IPAA) occurs in around 10% of the patients. Compared to patients with functioning pouches, health related quality of life is deteriorated after failure. Sexual function in patients with pouch failure is however poorly studied. The aim was to study sexual function in patients with pelvic pouch failure; patients with functioning pouches were used as controls. The hypothesis was that patients with pouch failure have worse sexual function. Methods: 36 patients with pouch failure were compared with 72 age and sex-matched controls with ulcerative colitis and functioning pouches. The patients answered a set of questionnaires concerning sexual function (Female Sexual Function Index [FSFI] and International Index of Erectile Function [IIEF]), body image (BIS-scale) and health-related quality of life (SF-36). Results: Both women and men with pouch failure scored lower than controls in the FSFI and IIEF questionnaires. However, none of the observations were statistically significant. The scores in the failure group (for both sexes) were below the cut-off level for sexual dysfunction. Scores for the BIS instrument were significantly lower for both sexes in the failure group. Women and men in the failure group scored lower than the controls in all domains of the SF-36, however statistically significant only for the social function domain in men. Conclusions: The hypothesis, that a failed IPAA is associated with worse sexual function, was not confirmed. Compared to patients with functioning pouches, patients with pouch failure have inferior body image.

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Ileal pouch–anal anastomosis

Cited by 102 publications

References 137 publications

Ulcerative Colitis Practice Guidelines in Adults: American College of Gastroenterology, Practice Parameters Committee

Ulcerative Colitis Practice Guidelines in Adults: American College of Gastroenterology, Practice Parameters Committee

Bekkenreservoarkirurgi

Sexual function after failed ileal pouch-anal anastomosis

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