Sepsis is a Major Predictor of Failure After Ileal Pouch-Anal Anastomosis

Abstract

Septic complications are the most common cause of ileal pouch-anal anastomosis failure. Careful patient selection and the prevention of septic complications may decrease the risk of this failure.

Complications following restorative proctocolectomy in children

“…Sixty patients (34 girls) underwent RPC at a median (range) age of 13.5 (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) years. The preoperative and operative characteristics of the study group and their indications for surgery are illustrated in Table 1.…”

“…[9][10][11]. In adult patients, exposure to steroids [3,12] and the use of a hand-sutured anastomosis [4] are thought to be causally associated with this complication.…”

Severity of inflammation as a risk factor for ileo-anal anastomotic leak after a pouch procedure in ulcerative colitis

“…An IAA leak is the single most important determinant of pouch failure, which can occur in up to 30 % of cases. Pouch failure can cause significant long-term morbidity including functional deterioration and requirement of subsequent operative intervention(s) [3,15,16]. Determining factors associated with increased risk of post-operative IAA leaks is imperative for patients with UC undergoing elective PPP.…”

Reoperative transabdominal surgery for ileoanal pouch salvage

“…[3][4][5][6][7] Primary diagnosis (ie Crohn's disease), development of anal pathology, anal sphincter dysfunction, patient comorbidities (ie weight gain), pelvic sepsis, anastomotic stricture and separation were found as predictors of pouch failure. 8,9 Pouch failure is a big tragedy for patients and some patients want to push the limits to salvage ileoanal pouch to avoid a permanent ileostomy. Surgical revision of the failed ileoanal pouch is the only option to salvage IPAA and maintain intestinal continuity.…”