Abstract. A woman with ulcerative colitis status post total pan-proctocolectomy and ileal pouch-anal anastomosis 17 years prior presented with recurrent ab

In 2023, I faced my biggest challenge to date – number 8 of my surgeries but this one would change my body forever. I was going to have a proctocolectomy or a Barbie butt/Ken butt. This meant I would be saying goodbye to a part of my body I have lived with all my life. When I was told I was going into surgery for an 8th time the nerves began again and the thoughts of what I was going to have to endure again, and more so the thoughts of the recovery.

A 37-year-old man with a history of total abdominal proctocolectomy and ileoanal anastomosis for familial adenomatous polyposis presents with abdominal pain, nausea and vomiting for the past month.…

This study reviews the evolution of proctocolectomy with ileal pouch-anal anastomosis surgery and its outcomes over three decades at the University Hospita

Anastomotic leakage (AL) is a leading cause of pouch failure post-restorative proctocolectomy, and early intervention significantly improves outcomes.AL occurred in 13.6% of patients, with higher rates in low-volume centers (28.0% vs. 12.7%).The overall salvage rate for AL was 85.4%, increasing to 92% with early diagnosis and treatment.Early assessment and targeted management can lead to better

Purpose Restorative proctocolectomy with ileal pouch anal anastomosis (IPAA) is a well codified procedure with low morbi-mortality and increasingly satisfactory functional results. We aimed to evaluate long-term quality of life and functional outcome of this procedure. Methods Retrospective, descriptive study of IPAA cases carried out over a period of 19 years [2001–2019], in the visceral and digestive surgery department of Sahloul Hospital. Anal incontinence was assessed using the St. Mark’s Incontinence Score (SMIS). We evaluated functional outcome using the Öresland Score (OS) and the Pouch Functional Score (PFS), and quality of life (QoL) using Cleveland Global Quality of Life (CGQL). Results 125 patients (50,4% females) with a median age at surgery of 40.5 ± 14.9 years. Response rate to the questionnaires was 91,2% (n = 114). Only the “J” shaped ileal pouch was made. The global postoperative morbidity was 36%. Most patients had a good functional outcome with a median OS of 5.3 ± 3.6 and a median PFS of 7,3 ± 6,1. The average diurnal bowel mouvement is 5 ± 2.1, while 83,3% (n = 96) had less than 7 diurnal bowel movements. The average of nocturnal bowel movement is 2.14 ± 1.59 while 70,1% (n = 80) had less than 2 nocturnal bowel movements. Most patients had a good QoL with a median CGQL of 18,4 ± 4,3. Conclusion The IAA with « J » shaped ileal pouch is a procedure ensuring sphincter function compatible with normal life. Future sexual and quality of life studies will need to elicit preoperative baselines. Trial registration number Research registry 9509.

Background The ileal pouch-anal anastomosis (IPAA) is a restorative procedure performed after proctocolectomy to improve quality of life in patients with colorectal conditions like ulcerative colitis, familial adenomatous polyposis, and selected cases of Crohn’s disease and Lynch syndrome. However, severe pouch dysfunction can occur, often necessitating further surgical intervention. Objective This technical note aims to describe the operative approach and perioperative management for diverting ileostomy as a treatment for dysfunctional ileoanal pouches. Methods Indications for the procedure include complications such as pelvic sepsis, pouchitis, fistulas, and Crohn’s disease of the pouch. Preoperative planning involves a multidisciplinary team, stoma site marking, and imaging to assess bowel integrity. The surgical technique utilizes laparoscopic access with careful adhesiolysis to minimize bowel injury, with intraoperative pouchoscopy to identify anatomical landmarks. An ileostomy is created by selecting a tension-free small bowel segment and approximating it to a pre-marked stoma site. Attention is given to preserving bowel length to allow for potential future restorative procedures. Postoperative care focuses on stoma management and addressing ongoing pouch dysfunction symptoms. Conclusions Diverting ileostomy offers symptom relief for patients with pouch dysfunction while avoiding more complex procedures like pouch excision. It is a valuable option in managing pouch failure.

A groundbreaking study conducted by UCLA Health has provided new insights into the use of an eight-strain probiotic formulation in reducing the incidence of pouchitis, a challenging inflammatory condition that afflicts many patients following colon removal surgery due to ulcerative colitis. This condition develops in patients who undergo restorative proctocolectomy, in which the colon and rectum are surgically removed, and a new internal reservoir, or “pouch,” is fashioned from the small intestine to restore bowel function without the need for an external ostomy.

Background Pouchitis is the most common complication of restorative proctocolectomy (RPC) with ileal

Background & Aims: Total proctocolectomy with ileal pouch anal anastomosis (IPAA) is the standard of