Document Detail


Endoscopy-assisted transanal division of an apical pouch bridge after restorative proctocolectomy with a J-shaped ileal pouch.
MedLine Citation:
PMID:  18936672     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Kazutoshi Takagi; Hitoshi Nagata; Mitsuru Ishizuka; Yuki Sakuraoka; Keiichi Kubota
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Surgical laparoscopy, endoscopy & percutaneous techniques     Volume:  18     ISSN:  1534-4908     ISO Abbreviation:  Surg Laparosc Endosc Percutan Tech     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-21     Completed Date:  2008-12-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100888751     Medline TA:  Surg Laparosc Endosc Percutan Tech     Country:  United States    
Other Details:
Languages:  eng     Pagination:  486-8     Citation Subset:  IM    
Affiliation:
Department of Gastroenterological Surgery, Dokkyo University School of Medicine, Kitakobayashi, Mibu, Shimotsuga, Tochigi, Japan. k-takagi@dokkyomed.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Anal Canal / 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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