IPAA surgery has evolved to assume a major role in the operative management of CUC and FAP. In experienced centres, the safety of performing this somewhat complex procedure, often in gravely ill patients, has been confirmed. A significant decrease in morbidity has accompanied increased experience and simplification of the operative techniques. Two major issues await resolution. The first has to do with the less than totally predictable functional results of IPAA surgery. While many patients do well, others, for no apparent reason, do poorly with excess frequency, urgency and incontinence. Whether operative modifications or preoperative testing can alter this outcome is at this time unclear. The second issue has to do with the potential long-term sequelae of IPAA surgery. Pouchitis and nutritional and metabolic consequences, including the potential for malignant transformation of ileal mucosa or of retained rectal mucosa, cannot be ignored. At present, these risks seem remote but only long-term follow-up will determine whether IPAA surgery deserves its current enthusiasm.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/0950-3528(92)90022-7 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Postoperative Outcomes of a Pelvic Pouch Procedure: Lessons Learned over 40 Years Among 5070 Patients.
J Gastrointest Surg
January 2025
Cleveland Clinic, Cleveland, Ohio Department of Colorectal Surgery. Electronic address:
Background: This study aims to report the experience over 40 years and outcomes of 5070 patients who underwent a pelvic pouch procedure.
Methods: A retrospective analysis of a prospectively maintained IPAA database- (1983 - 2022) was performed. Patients were stratified based on the diagnosis: ulcerative colitis (UC), indeterminate colitis (IC), familial adenomatous polyposis (FAP), inflammatory bowel disease-dysplasia, Crohn's colitis (CD), and others.
Medical, Endoscopic, and Surgical Treatments for Rectal Cuffitis in IBD Patients with an Ileal Pouch-Anal Anastomosis: A Narrative Review.
Dig Dis Sci
January 2025
Department of Gastroenterology, Hepatology, and Nutrition, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
Background: Ulcerative colitis patients who undergo ileal pouch-anal anastomosis (IPAA) without mucosectomy may develop inflammation of the rectal cuff (cuffitis). Treatment of cuffitis typically includes mesalamine suppositories or corticosteroids, but refractory cuffitis may necessitate advanced therapies or procedural interventions. This review aims to summarize the existing literature regarding treatments options for cuffitis.
View Article and Find Full Text PDFRisk of cancer and reoperation after ileorectal anastomosis and ileal pouch-anal anastomosis in familial adenomatous polyposis.
Am J Gastroenterol
December 2024
Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
Objectives: To prevent colorectal cancer (CRC), most patients with familial adenomatous polyposis (FAP) undergo (procto)colectomy with ileorectal anastomosis (IRA) or ileal pouch-anal anastomosis (IPAA). After surgery, these patients remain at risk of developing cancer in the remnant rectum or rectal cuff/pouch. We aimed to compare the long-term risk of cancer following IRA or IPAA in FAP.
View Article and Find Full Text PDFEffect of obesity on postoperative complications in ulcerative colitis: A systematic review and meta-analysis.
Ann Gastroenterol Surg
January 2025
Department of Surgery, Transplantation and Gastroenterology Semmelweis University Budapest Hungary.
Article Synopsis
- The study investigates the impact of obesity on postoperative complications in ulcerative colitis patients undergoing a specific surgery (IPAA).
- Results showed no significant difference in overall complication rates between obese and non-obese patients, though obese patients had slightly longer hospital stays.
- The findings highlight low certainty of evidence, suggesting further research is needed to draw definitive conclusions.
Preventive effect of Clostridium butyricum MIYAIRI against pouchitis in children with ulcerative colitis.
Surg Today
December 2024
Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Edobashi 2-174, Tsu, Mie, 514-8507, Japan.
Purpose: Pouchitis is a major complication after ileal pouch-anal anastomosis (IPAA) for ulcerative colitis in children (UCc). In this study, we investigated whether the oral administration of Clostridium butyricum MIYAIRI 588 (CBM) can reduce the incidence of pouchitis after IPAA in UCc.
Methods: We reviewed the data for pediatric patients with UC, who underwent IPAA in Mie University Hospital between 2004 and 2022.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!