Ileocecal Reservoir Reconstruction with Physiologic Function After Total Mesorectal Cancer Excision

Flüe, M O von; Degen, Lukas; Beglinger, C; Hellwig, A C; Rothenbühler, J M; Harder, F.

doi:10.1097/00000658-199608000-00014

Cited by 52 publications

(24 citation statements)

References 33 publications

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“…Ileocecal interposition was initially introduced by von Flüe and Harder [4] and was later presented as an alternative method for rectal replacement after rectal resection for cancer [5] and complicated radiation proctitis [6]. It has also been used as a substitute for stomach and distal esophagus replacement[ 14, 15].…”

Section: Discussionmentioning

confidence: 99%

“…Ileocecal interposition has been demonstrated not to alter gastrointestinal transit [16]. In the initial reports, ileocecal interposition seemed to achieve the same quality of continence, but seemed to be superior with respect to defecation quality [5, 6]. However, long-term results did not reveal better evacuation, as more than 50% of the patients were complaining of fragmentation after 5 years [17].…”

Section: Discussionmentioning

confidence: 99%

“…In cases with a native ileocecal segment, one has the choice to either anastomose the terminal ileum to the aboral boarder of the colon as originally described by von Flüe et al [5, 6] or to anastomose the terminal colon to the cecum as we did in patient 1. There is probably no functional difference between the two methods, but as we had seen significant complications after ileocecal resection in patients who later had radiotherapy [19], we prefer the colocecal anastomosis when additional length of ileal segment is not necessary to construct a tension-free proximal anastomosis.…”

Section: Discussionmentioning

confidence: 99%

“…An appendectomy had already been performed previously. This segment was rotated counterclockwise into the pelvis as previously described [5, 6]. The anastomosis was constructed lateroterminally with a two-layered technique, and a 24-Ch catheter was inserted transanally into the cecum reservoir.…”

Section: Patientsmentioning

confidence: 99%

“…The technique is a modification of the method that was initially described by von Flüe and Harder [4] and was later presented as a first-line reconstruction after total mesorectal excision for rectal cancer [5] or as a rectal substitute after rectal resection for radiation proctitis [6]. …”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Modified Ileocecal Interposition – The Final Sphincter-Saving Solution after Failed Salvage Surgery for Anastomotic Complications of Low Anterior Resection

Rink

Vestweber²,

Vestweber³

2008

Dig Surg

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Introduction: Reversal of low Hartmann’s procedures can be a challenging operation. We report on the successful treatment of patients who have already had prior salvage surgery for complications of a low colorectal anastomosis presenting with active fistulas from the rectal remnant. Methods: An ileocolic segment was mobilized with the neurovascular pedicle of the ileocolic artery and turned counterclockwise into the pelvis. The fistulas were cured and a hand-sutured coloanal anastomosis was performed at the level of the dentate line. Almost the entire length of the remnant colon was preserved. Results: There was no morbidity. The functional outcome was good or reasonable and the subjective satisfaction with the outcome was very high. Conclusion: We conclude that an ileocolic segment is an excellent substitute for reversal of low Hartmann’s procedures even in patients in whom prior salvage surgery has failed. As the functional outcome is slightly inferior to other alternatives for rectal replacement, its use should be restricted to patients with complex local situations or in whom alternative reconstructions would result in significant loss of bowel length.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Patientsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Modified Ileocecal Interposition – The Final Sphincter-Saving Solution after Failed Salvage Surgery for Anastomotic Complications of Low Anterior Resection

Rink

Vestweber²,

Vestweber³

2008

Dig Surg

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Quantitative Short-term Study of Anal Sphincter Function After Chemoradiation for Rectal Cancer

et al. 2001

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Ileocecal Interpositional Graft as Gastric Replacement After Total Gastrectomy and Distal Esophagectomy

Flüe

Metzger²,

Harder³

1997

Arch Surg

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The ileocecal interpositional graft is an alternative method for replacing the distal esophagus and the stomach. A pedunculated ileocecal interpositional graft rotated 180 degrees clock-wise and placed across the hiatus between the proximal esophagus and the duodenum could act as a reservoir and protect against reflux (ileocecal valve) while preserving the duodenal passage. Two patients underwent this operation (the first patient has been observed for 12 postoperative months). We also used this technique to replace the stomach alone below the diaphragm, a technique that had been abandoned in the surgical literature since 1952, although the concept and initial experiences were already promising at that time. In favor of these attractive features of the ileocecal interpositional graft as gastric replacement, we have begun a controlled examination of this method.

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Ileocecal Reservoir Reconstruction with Physiologic Function After Total Mesorectal Cancer Excision

Cited by 52 publications

References 33 publications

Modified Ileocecal Interposition – The Final Sphincter-Saving Solution after Failed Salvage Surgery for Anastomotic Complications of Low Anterior Resection

Modified Ileocecal Interposition – The Final Sphincter-Saving Solution after Failed Salvage Surgery for Anastomotic Complications of Low Anterior Resection

Quantitative Short-term Study of Anal Sphincter Function After Chemoradiation for Rectal Cancer

Ileocecal Interpositional Graft as Gastric Replacement After Total Gastrectomy and Distal Esophagectomy

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