| Interposition of a gastric pouch between ileum and anus after proctocolectomy: long-term results in 3 patients. | |
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MedLine Citation:
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PMID: 19375617 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: After proctocolectomy, ileal pouch-anal anastomosis may not be feasible, especially in the case of desmoid tumor or after failed ileal pouch-anal anastomosis requiring excision of the pouch. We designed a gastric pouch interposed between the terminal ileum and the anus to avoid a permanent ileostomy for these patients. Long-term results and quality of life with this technique remain unknown. METHODS: After proctocolectomy, ileal pouch-anal anastomosis was not feasible or had failed in 3 patients (2 with familial adenomatous polyposis and 1 with ulcerative colitis; 40, 49, and 50 years of age, respectively). Of these patients, 2 had undergone end ileostomy 7 and 8 years previously. A pouch was created using the left half of the gastric fundus, supplied through the right gastroepiploic vessels; the pouch was anastomosed proximally to the terminal ileum and distally to the anus. Diverting ileostomy was performed in all patients. RESULTS: After a mean follow-up of 6 years, all 3 patients were highly satisfied with the operation and described their quality of life as good. The median stool frequency during the day and night were 6 and 1, respectively. No patient reported incontinence or urgency. Of the 3 patients, 2 had minimal soiling with gastric juice; 1 patient had anastomotic ulcers with bleeding requiring resection with reanastomosis. All of the patients needed long-term proton pump inhibitor therapy and topical perianal treatment to prevent skin burning. CONCLUSION: Inter-ileoanal gastroplasty is a surgical salvage technique that can avoid a permanent ileostomy. The procedure provides a good quality of life for patients with unfeasible or failed ileal pouch. |
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Authors:
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Pablo Ortega-Deballon; Nicolas Cheynel; Giovanni Di-Giacomo; Rezkallah Hareth; Olivier Facy; Patrick Rat |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Surgery Volume: 145 ISSN: 1532-7361 ISO Abbreviation: Surgery Publication Date: 2009 May |
Date Detail:
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Created Date: 2009-04-20 Completed Date: 2009-05-05 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0417347 Medline TA: Surgery Country: United States |
Other Details:
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Languages: eng Pagination: 568-72 Citation Subset: AIM; IM |
Affiliation:
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Department of Digestive Surgery, University Hospital, Dijon, France. pablo.ortega-deballon@chu-dijon.fr |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adenomatous Polyposis Coli
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surgery* Adult Colitis, Ulcerative / surgery* Colonic Pouches* Female Follow-Up Studies Gastroplasty / methods* Humans Male Middle Aged Proctocolectomy, Restorative / methods* Quality of Life Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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