Background: Congenital pouch colon (CPC) is an unusual anomaly with an unique geographical distribution. The aim of this study was to find out the incidence of CPC among anorectal malformation (ARM) cases in our institute and to compare the outcome between conventional three-staged surgery versus two-staged management approach.
Materials And Methods: This study was conducted in the department of pediatric surgery over a period of 7 years from 1 April 2013 to 31 March 2020.
Results: Out of 754 cases of ARMs, 43 cases of CPC were detected. The incidence of pouch colon among patients with high ARMs was found to be 7.6% with a male predominance (M:F = 4.4:1). The anomaly was diagnosed in 72% of our patients preoperatively and Type IV variety was the most common intra-operative finding. The survival after initial hospitalisation was 82% and 88% in three-stage and two-stage surgical procedures, respectively. However, the final clinical outcome after the completion of all stages of surgery and follow-up was better in two-staged approach (54% vs. 47%).
Conclusion: Although, CPC is a rare anomaly, the incidence in our institute is 7.6% among high ARM cases. As compared to conventional three-staged surgery, the two-staged management approach has the advantage of better survival and decreased morbidity.
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http://dx.doi.org/10.4103/ajps.AJPS_53_20 | DOI Listing |
Annu Rev Med
January 2025
Department of Medicine, University of California San Diego, La Jolla, California, USA.
Chronic pouchitis (CP) occurs in approximately 20% of patients with ulcerative colitis after total proctocolectomy with ileal pouch anal anastomosis and is categorized as antibiotic dependent, antibiotic refractory, or Crohn's disease-like. The management of CP is challenging because of limited evidence and few randomized controlled trials. In this review, we discuss the medical management of CP and its supporting data delineated by type of therapy.
View Article and Find Full Text PDFBJS Open
December 2024
Department of Abdominal Surgery, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
Background: Proctocolectomy with ileal pouch-anal anastomosis is the treatment of choice for patients with ulcerative colitis with medical refractory disease or dysplasia. The aim of this research was to describe the evolution of ileal pouch-anal anastomosis surgery and surgical outcomes over a three-decade interval in a high-volume referral centre.
Methods: All consecutive patients undergoing ileal pouch-anal anastomosis for ulcerative colitis between 1990 and 2022 at the University Hospitals of Leuven were retrospectively included.
Nat Commun
January 2025
University of Chicago, Department of Medicine, Chicago, IL, USA.
Total proctocolectomy with ileal pouch anal anastomosis is the standard of care for patients with severe ulcerative colitis. We generated a cell-type-resolved transcriptional and epigenetic atlas of ileal pouches using scRNA-seq and scATAC-seq data from paired biopsy samples of the ileal pouch and the ileal segment above the pouch (pre-pouch) from patients (male=4, female=2), and paired biopsies of the terminal ileum and ascending colon from healthy individuals (male=3, female=3) serving as reference. Our study finds an additional population of absorptive and secretory epithelial cells within the pouch but not the pre-pouch.
View Article and Find Full Text PDFTransl Androl Urol
November 2024
Division of Urology, Department of Surgery, University of Utah, Salt Lake City, UT, USA.
Background: There is limited data within the urologic literature regarding bowel complications and leak rates following surgery requiring ileocolic anastomoses such as right colon pouch (RCP) and continent cutaneous ileocecocystoplasty (CCIC). We aimed to establish ileocolic anastomotic leak rates in urologic reconstructive surgery and determine bowel-related complications following RCP and CCIC surgeries.
Methods: We reviewed adult patients who underwent RCP or CCIC (2010-2022), investigating patient characteristics, perioperative variables, and outcomes.
Inflamm Bowel Dis
December 2024
Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Background: Pouchitis is the most common complication of restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis (IPAA) in patients with ulcerative colitis (UC). We previously reported the presence of anti-integrin αvβ6 antibodies in the serum of patients with UC. This study investigated the association between anti-integrin αvβ6 antibodies and the development of pouchitis in patients with UC.
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