Prevalence and Management of Prolapse of the Ileoanal Pouch

Ehsan, Mitra; Isler, John T.; Kimmins, Mark H.; Billingham, Richard P.

doi:10.1007/s10350-004-0511-5

Cited by 52 publications

(35 citation statements)

References 10 publications

(10 reference statements)

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“…In 2003, Ehsan et al 7 , reported on 83 patients with pouch prolapse. These data were based on a survey of all North American members and fellows of The American…”

Section: Discussionmentioning

confidence: 98%

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Ileal Pouch Prolapse: Prevalence, Management, and Outcomes

Joyce

Fazio

Hull

et al. 2010

Journal of Gastrointestinal Surgery

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“…In 2003, Ehsan et al 7 , reported on 83 patients with pouch prolapse. These data were based on a survey of all North American members and fellows of The American…”

Section: Discussionmentioning

confidence: 98%

“…[4][5][6] Ileal pouch prolapse is a rarely reported complication. One previous study, 7 reported the condition in 83 patients in a survey of colorectal surgeons in North America. While there was a 94% success rate reported with surgical repair, there were no data on long-term follow-up with associated recurrences.…”

Section: Introductionmentioning

confidence: 98%

Ileal Pouch Prolapse: Prevalence, Management, and Outcomes

Joyce

Fazio

Hull

et al. 2010

Journal of Gastrointestinal Surgery

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“…The main inconvenience is that right colic arcade preservation is time-consuming and might potentially lead to more ileal pouch intussusception or prolapse, otherwise already described after IPAA [31,32]. Another drawback is an increased risk of pouch ischemia [14,31].…”

Section: Optimizing Mesenteric Lengtheningmentioning

confidence: 99%

Restorative proctocolectomy and ileal pouch-anal anastomosis for familial adenomatous polyposis revisited

et al. 2006

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Since restorative proctocolectomy (RPC) with ileal-pouch anal anastomosis (IPAA) removes the entire diseased mucosa, it has become firmly established as the standard operative procedure of choice for familial adenomatous polyposis (FAP). Many technical controversies still persist, such as mesenteric lengthening techniques, close rectal wall proctectomy, endoanal mucosectomy vs. double stapled anastomosis, loop ileostomy omission and a laparoscopic approach. Despite the complexity of the operation, IPAA is safe (mortality: 0.5-1%), it carries an acceptable risk of non-life-threatening complications (10-25%), and it achieves good long-term functional outcome with excellent patient satisfaction (over 95%). In contrast to the high incidence in patients operated for ulcerative colitis (UC) (15-20%), the occurrence of pouchitis after IPAA seems to be rare in FAP patients (0-11%). Even after IPAA, FAP patients are still at risk of developing adenomas (and occasional adenocarcinomas), either in the anal canal (10-31%) or in the ileal pouch itself (8-62%), thus requiring lifelong endoscopic monitoring. IPAA operation does not jeopardise pregnancy and childbirth, but it does impair female fecundity and has a low risk of impairment of erection and ejaculation in young males. The latter can almost completely be avoided by a careful "close rectal wall" proctectomy technique. Some argue that low risk patients (e.g. <5 rectal polyps) can be identified where ileorectal anastomosis (IRA) might be reasonable. We feel that the risk of rectal cancer after IRA means that IPAA should be recommended for the vast majority of FAP patients. We accept that in some very selected cases, based on clinical and genetics data (and perhaps influenced by patient choice regarding female fecundity), a stepwise surgical strategy with a primary IPA followed at a later age by a secondary proctectomy with IPAA could be proposed.

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“…The pathogenesis is unknown, but there has been a theoretical consideration about the tension of pouch mesenterium. Patients presents with a sensation of incomplete evacuation, seepage, Surgical treatment was performed in 52 patients through transanal, transabdominal or combined approach, with a success rate of 94 % [4]. A single-centre study reports similar numbers, with an overall incidence of 0.3 % (11 out of 3,176 patients).…”

Section: Discussionmentioning

confidence: 99%

“…Therefore the experience with management of the complication is very limited. The surgical treatments reported include transanal repair, transabdominal pouchopexy and transabdominal revision or removal [3,4]. A single case-report describes a successful robotic-assisted laparoscopic pouchopexy [5].…”

Section: Introductionmentioning

confidence: 99%

Ileoanal J-Pouch Prolapse: Successful Laparoscopic Pouchopexy with a Biological Mesh

Steinthorsdottir

Bulut

2017

GHOA

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Background and aims: Prolapse of ileal pouch is uncommon complication and the surgical treatment of this entity is very challenging. Only a few reports in the literature describe the repair of pouch prolapse with synthetic material, and there is no report describing the use of a biological mesh. Methods: Case reportResults: A 34-year old female was diagnosed with colitis ulcerosa at the age of 29. One year after she had a subtotal colectomy and two years later, she underwent completion proctectomy with an ileo-anal J pouch (IPAA). Both procedures were performed by open approach. The patient developed a recurrent full-thickness prolapse of the pouch that failed the initial nonoperative management and she was successfully treated with laparoscopic pouchopexy, using a biological mesh. Conclusion:Laparoscopic pouchopexy with a biological mesh appears to be a reasonable option in the surgical management of a full-thickness prolapse of ileoanal J-pouch prolapse.

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Prevalence and Management of Prolapse of the Ileoanal Pouch

Cited by 52 publications

References 10 publications

Ileal Pouch Prolapse: Prevalence, Management, and Outcomes

Ileal Pouch Prolapse: Prevalence, Management, and Outcomes

Restorative proctocolectomy and ileal pouch-anal anastomosis for familial adenomatous polyposis revisited

Ileoanal J-Pouch Prolapse: Successful Laparoscopic Pouchopexy with a Biological Mesh

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