| Endoscopy-assisted transanal division of an apical pouch bridge after restorative proctocolectomy with a J-shaped ileal pouch. | |
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MedLine Citation:
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PMID: 18936672 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Restorative proctocolectomy and J-shaped ileal pouch-anal anastomosis have been performed as a standard operation for ulcerative colitis. However, functional problems are sometimes troublesome in the postoperative period. The J pouch was constructed from 2 ileal limbs using the gastrointestinal anastomosis (GIA) stapler. A residual mucosal bridge remained because the stapler had a safety margin at the top of the cartridge. Apical pouch bridge is a residual septum above the ileoanal anastomosis. There are several reports of so-called apical pouch bridge syndrome due to outlet obstruction of the J-shaped ileal pouch by an apical bridge. Division of this septum can resolve the outlet obstruction. We describe a successful endoscopic procedure for division of an apical pouch bridge. An Endo-GIA stapler was introduced into the ileal pouch alongside the endoscope, and division of the apical bridge required a few firings of the Endo-GIA stapler under transanal endoscopic guidance. The symptoms related to the apical pouch bridge were resolved completely without creation of an ileostomy. |
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Authors:
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Kazutoshi Takagi; Hitoshi Nagata; Mitsuru Ishizuka; Yuki Sakuraoka; Keiichi Kubota |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Surgical laparoscopy, endoscopy & percutaneous techniques Volume: 18 ISSN: 1534-4908 ISO Abbreviation: Surg Laparosc Endosc Percutan Tech Publication Date: 2008 Oct |
Date Detail:
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Created Date: 2008-10-21 Completed Date: 2008-12-23 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100888751 Medline TA: Surg Laparosc Endosc Percutan Tech Country: United States |
Other Details:
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Languages: eng Pagination: 486-8 Citation Subset: IM |
Affiliation:
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Department of Gastroenterological Surgery, Dokkyo University School of Medicine, Kitakobayashi, Mibu, Shimotsuga, Tochigi, Japan. k-takagi@dokkyomed.ac.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anal Canal
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surgery* Colitis, Ulcerative / surgery Colonic Pouches / adverse effects* Endoscopy, Gastrointestinal / methods* Humans Ileum / surgery* Postoperative Complications / surgery Proctocolectomy, Restorative / adverse effects*, methods Surgical Staplers |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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