Anastomotic Leak after Ileal Pouch–Anal Anastomosis

2021 ◽  
Vol 34 (06) ◽  
pp. 417-425
Author(s):  
Kristina Guyton ◽  
David Kearney ◽  
Stefan D. Holubar

AbstractThere are special considerations when treating anastomotic leak after restorative proctocolectomy and ileal pouch–anal anastomosis. The epidemiology, risk factors, anatomic considerations, diagnosis and management, as well as the short- and long-term consequences to the patient are unique to this patent population. Additionally, there are specific concerns such as “tip of the J” leaks, transanal management of anastomotic leak/presacral sinus, functional outcomes after leak, and considerations of redo pouch procedures.

2019 ◽  
Vol 25 (7) ◽  
pp. 1152-1168 ◽  
Author(s):  
Amy L Lightner ◽  
Ahmad Alsughayer ◽  
Zhen Wang ◽  
Nicholas P McKenna ◽  
Mohamed O Seisa ◽  
...  

2019 ◽  
Vol 14 (6) ◽  
pp. 726-733 ◽  
Author(s):  
Pramodh Chandrasinghe ◽  
Michele Carvello ◽  
Karin Wasmann ◽  
Caterina Foppa ◽  
Pieter Tanis ◽  
...  

Abstract Background The transanal approach to ileal pouch-anal anastomosis [Ta-IPAA] provides better access to the lower pelvis with lower short-term morbidity in ulcerative colitis [UC]. The aim of this study was to assess the long-term functional outcomes after Ta-IPAA vs transabdominal IPAA [Abd-IPAA] in UC. Methods A multicentre cohort analysis was performed between March 2002 and September 2017. Patient characteristics, surgical details and postoperative outcomes were compared. CGQL [Cleveland global quality of life] score at 12 months with a functioning pouch was considered the primary end point. Results A total of 374 patients [100 Ta-IPAA vs 274 Abd-IPAA] were included. Ta-IPAA demonstrated a comparable overall quality of life [CGQL score] to Abd-IPAA [0.75 ± 0.11 vs 0.71 ± 0.14; respectively, p = 0.1]. Quality of life [7.71 ± 1.17 vs 7.30 ± 1.46; p = 0.04] and energy-level items [7.16 ± 1.52 vs 6.66 ± 1.68; p = 0.03] were significantly better after Ta-IPAA, while the quality of health item was comparable [7.68 ± 1.26 vs 7.64 ± 1.44; p = 0.96]. Analysis excluding anastomotic leaks did not change the overall CGQL scores. Stool frequencies [>10/24 h: 22% vs 21%; p = 1.0] and the rate of a single episode of major incontinence during the following 12-month period [27% vs 26%; p = 0.89] were similar. The differences in 30-day morbidity rates [33% vs 41%; p = 0.2] and anastomotic leak rates were not significant [6% vs 13%; p = 0.09]. Conclusions This study provides evidence of comparable long-term functional outcome and quality of life after Ta-IPAA and Abd-IPAA for UC.


2018 ◽  
Vol 24 (8) ◽  
pp. 1857-1865 ◽  
Author(s):  
Nicholas P McKenna ◽  
Kellie L Mathis ◽  
John H Pemberton ◽  
Amy L Lightner

2022 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Elizabeth J. Olecki ◽  
Anthony P. Kronfli ◽  
Kelly A. Stahl ◽  
Steven King ◽  
Nina Razavi ◽  
...  

2016 ◽  
Vol 70 (1) ◽  
pp. 38-44
Author(s):  
Marta Kostrejová ◽  
Martin Bortlík ◽  
Dana Ďuricová ◽  
Martin Kolář ◽  
Richard Sequens ◽  
...  

2017 ◽  
Vol 225 (4) ◽  
pp. S47-S48
Author(s):  
Nicholas P. McKenna ◽  
Kellie L. Mathis ◽  
Eric J. Dozois ◽  
Amy L. Lightner

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