Management and Treatment Outcome of Pouch-Vaginal Fistulas Following Restorative Proctocolectomy

Shah, Nirav; Remzi, Feza H.; Massmann, Arndt; Baixauli, Jorge; Fazio, Victor W.

doi:10.1007/s10350-004-6684-0

Cited by 115 publications

(81 citation statements)

References 27 publications

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“…The majority of studies have reported that pouchitis is the most frequent long-term complication of the IPAA, ranging from 12% to 50% (18,19). Pouch-vaginal fistula has been reported as a major complication in women undergoing IPAA, of which the incidence ranges from 3.3%-12% (20)(21)(22). Small bowel obstruction following IPAA varies between 12-24% (23).…”

Section: Discussionmentioning

confidence: 99%

Risk factors for complications after total colectomy in ulcerative colitis

Kim

Park²,

Kang³

et al. 2012

Turk J Gastroenterol

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Section: Discussionmentioning

confidence: 99%

Risk factors for complications after total colectomy in ulcerative colitis

Kim

Park²,

Kang³

et al. 2012

Turk J Gastroenterol

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“…Structural or OO dysfunctions have better results compared with septic complications. 7,11,12,17,28 Thus, it is important to distinguish between these entities and to know the aetiology of pouch malfunctions in order to choose the optimal treatment. The commonest conditions of surgical interest are discussed below; medical conditions and conservative management will also be briefly addressed.…”

Section: Discussionmentioning

confidence: 99%

“…15 Pouch retention rates after reconstructive surgery range between 0 and 50%. 12,[17][18][19][20][21][22][23][24][25][26][27] Indications for pouch salvage surgery affect the outcomes. For this reason, we propose a classification of reasons for pouch salvage in Table 4.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Salvage Surgery for Ileal Pouch Complications and Dysfunctions. The Experience of a Referral Centre and Review of Literature

Pellino¹,

Selvaggi²

2015

ECCOJC

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Background and Aims: Failure rates of restorative proctocolectomy with ileo pouch-anal anastomosis (IPAA) range between 3.5 and 15%. Salvage surgery aims to preserve the pouch and transanal evacuation. We report our experience with salvage, review the outcomes of revisional pouch surgery, and propose a classification of pouch dysfunction. Methods: We collected data on patients undergoing pouch salvage surgery between 1987 and 2014 at our hospital. Pre-and post-salvage functional data were assessed. Function at the 3-year follow-up was compared with that of matched IPAA controls (study patients:controls, 1:3). Results: Considering only patients who underwent primary IPAA at our centre (n = 31), 5-year failure was higher after salvage compared with primary IPAA (28.8 vs 5.7% log rank test, p = 0.005). Overall, we included 39 patients, with eight additional patients who received primary IPAA elsewhere, undergoing 46 procedures. Most patients had a J-pouch (74.4%) and needed salvage for septic complications. A transperineal approach was used in 22 patients, whereas 17 underwent abdominal salvage, with 77.3 and 64.7% success rates, respectively. Minor surgery was effective but required repeated procedures. Overall failure was 28.2% at a median follow-up of 42 (1-153) months. A significant decrease in bowel frequency (p = 0.021) and rate of urgency (p = 0.009) was observed at the 3-year follow-up after salvage in 25 patients available for comparison. Functional results after major salvage procedures were poorer compared with healthy IPAA controls (p = 0.003). Conclusions: Salvage surgery is effective and safe in experienced teams, but the 5-year failure rate is higher after salvage than after successful primary pouch surgery. Sepsis brings about a higher risk of failure compared with mechanical causes of dysfunction.

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“…Detailed information on salvage using abdominal pouch advancement is lacking 2,3 . Experience with this approach is reported.…”

Section: Introductionmentioning

confidence: 99%

Ileal pouch–vaginal fistula treated by abdominoanal advancement of the ileal pouch

Zinicola

Wilkinson

Nicholls

2003

British Journal of Surgery

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Management and Treatment Outcome of Pouch-Vaginal Fistulas Following Restorative Proctocolectomy

Cited by 115 publications

References 27 publications

Risk factors for complications after total colectomy in ulcerative colitis

Risk factors for complications after total colectomy in ulcerative colitis

Outcomes of Salvage Surgery for Ileal Pouch Complications and Dysfunctions. The Experience of a Referral Centre and Review of Literature

Ileal pouch–vaginal fistula treated by abdominoanal advancement of the ileal pouch

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