Background: Restorative proctocolectomy with ileal pouch-anal anastomosis is the surgical treatment of choice for patients requiring surgery for inflammatory bowel disease. A stricture located at the inlet of the afferent limb can lead to small bowel obstruction in a limited number of patients with a pelvic pouch. This paper aims to examine our experience with afferent limb stricture surgical correction when other endoscopic treatment methods have failed to control obstructive symptoms.
Methods: All consecutive eligible patients with ileal pouch-anal anastomosis and afferent limb stricture were identified from our institutional review board-approved database from 1990 to 2021. Patients surgically treated with excision and reimplantation/strictureplasty of afferent limb stricture were included in this study.
Results: Twenty patients met our inclusion criteria. Fifteen (75%) were female, and the overall mean age was 41 ± 10.3 years at afferent limb stricture surgery. The interval from ileal pouch-anal anastomosis formation to surgery for afferent limb stricture was 13.5 ± 6.7 years. Nine (45%) underwent strictureplasty, and 11 (55%) had resection and reimplantation of the afferent limb into the pouch. Before afferent limb stricture surgery, 3 (15%) required a diverting ileostomy for their obstructive symptoms. An additional 12 (60%) had a stoma constructed during afferent limb stricture surgery, and 5 had a strictureplasty and no stoma. Postoperatively, 1 patient (5%) had a leak at the afferent limb stricture repair site. All patients had their ileostomy closed 3.2 (2.99-3.6) months after surgery. Long-term after afferent limb stricture surgery, recurrent small bowel obstruction symptoms recurred in 7 (35%) patients 3.9 (2.6-5.8) years later.
Conclusion: Afferent limb stricture can be treated effectively with salvage surgery. The surgical intervention appears durable and provides an acceptable outcome for their obstructive symptoms.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.surg.2023.03.006 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Effects of dynamic elastomeric fabric orthoses in children with cerebral palsy: A single-blind randomized controlled trial.
Prosthet Orthot Int
December 2024
Department of Physiotherapy and Rehabilitation Faculty of Health Sciences, Gazi University, Ankara, Turkey.
Background: The dynamic elastomeric fabric orthoses (DEFOs) are made of neoprene material, providing the right biomechanical alignment and afferent input in the trunk, pelvis, and extremities, potentially allowing individuals to actively participate in daily life.
Objective: The aim of this study was to investigate the effects of DEFOs applied to the lower trunk and pelvis, on balance, gait parameters, and pelvic symmetry in children with cerebral palsy (CP).
Study Design: An evaluator-blinded randomized controlled trial.
The role of lymphatic system transfer (LYST) for treatment of lymphedema: A long-term outcome study of SCIP flap incorporating the lymph nodes and the afferent lymphatic vessels.
J Plast Reconstr Aesthet Surg
November 2024
Department of Plastic and Reconstructive Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan.
Background: Vascularized lymph node transfer (VLNT) is traditionally performed in patients with advanced-stage lymphedema. To enhance and promote the physiological effects of VLNT, lymphatic system transfer (LYST) was developed. In this technique, lymph nodes and a portion of their corresponding afferent lymphatic vessels are transferred to stimulate lymphangiogenesis.
View Article and Find Full Text PDFAssociative brain computer interface training increases wrist extensor corticospinal excitability in subacute stroke patients.
J Neurophysiol
December 2024
Institute of Sport and Sport Science, Albert-Ludwigs-Universität Freiburg, Freiburg, Germany.
Article Synopsis
- A new brain-computer interface (BCI) system uses electroencephalography to time stimulation with motor cortex activity, showing promise in helping stroke patients recover movement.
- A study with 24 subacute stroke patients tested this BCI on upper limb weakness, comparing an intervention group with a sham control group.
- Results showed that the intervention group had significantly increased muscle responses after training, demonstrating the potential for enhanced motor function in stroke recovery.
Future spinal reflex is embedded in primary motor cortex output.
Sci Adv
December 2024
Department of Developmental Physiology, National Institute for Physiological Sciences, National Institute of Natural Sciences, Okazaki, Aichi 4448585, Japan.
Mammals can execute intended limb movements despite the fact that spinal reflexes involuntarily modulate muscle activity. To generate appropriate muscle activity, the cortical descending motor output must coordinate with spinal reflexes, yet the underlying neural mechanism remains unclear. We simultaneously recorded activities in motor-related cortical areas, afferent neurons, and forelimb muscles of monkeys performing reaching movements.
View Article and Find Full Text PDFA single exposure to prolonged flexor carpi radialis muscle vibration increases sensorimotor cortical areas activity.
J Neurophysiol
December 2024
Université Jean Monnet Saint-Etienne, Lyon 1, Université Savoie Mont-Blanc, Laboratoire Interuniversitaire de Biologie de la Motricité, F-42023, Saint-Etienne, France.
Prolonged local vibration (LV) is thought to promote brain plasticity through repeated Ia afferents discharge. However, the underlying mechanisms remain unclear. This study therefore aimed at determining the acute after-effects of 30-min LV of the flexor carpi radialis muscle (FCR) on sensorimotor (S1, M1) and posterior parietal cortex (PPC) areas activity.
View Article and Find Full Text PDFWant 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!