OBJECTIVES: The purpose of this study was to report our large, single-center experience of transabdominal ileal pouch-anal anastomoses (IPAA) redo surgery for a failed initial IPAA. BACKGROUND: IPAA fail from 3% to 15% of the times, mainly due to technical or inflammatory conditions. There is limited information about the surgical, functional, and quality-of-life (QOL) outcomes of redo surgery for failed IPAA, especially in large series of patients. METHODS: Patients undergoing transabdominal redo surgery for failed IPAA between 1983 and 2014 were evaluated. Primary endpoints were morbidity of the surgery, the proportion of patients with a functioning pouch, frequency of defecation and incidence of incontinence, and the patients' perception of QOL. RESULTS: There were 502 (43% males) patients with a median age of 38 years and median body mass index 24 kg/m at the time of revision surgery. A new pouch was created in 41% of patients whereas 59% had their original pouch revised and retained. Postoperative mortality was 0% and morbidity was 53%. The short-term anastomotic leak rate was 8%. At a median follow-up of 7 years after redo surgery, 101 (n = 20%) patients had redo IPAA failure. Pelvic sepsis developing after redo ileal pouch surgery was the primary indicator of pouch failure (hazard ratio, 3.691; 95% confidence interval, 2.411-5.699; P < 0.0001). Overall functional outcomes and QOL scores were acceptable. CONCLUSIONS: Patients with a failed ileoanal pouch may be offered redo pouch surgery with a high likelihood of success in terms of function and QOL.
OBJECTIVES: The purpose of this study was to report our large, single-center experience of transabdominal ileal pouch-anal anastomoses (IPAA) redo surgery for a failed initial IPAA. BACKGROUND:IPAA fail from 3% to 15% of the times, mainly due to technical or inflammatory conditions. There is limited information about the surgical, functional, and quality-of-life (QOL) outcomes of redo surgery for failed IPAA, especially in large series of patients. METHODS:Patients undergoing transabdominal redo surgery for failed IPAA between 1983 and 2014 were evaluated. Primary endpoints were morbidity of the surgery, the proportion of patients with a functioning pouch, frequency of defecation and incidence of incontinence, and the patients' perception of QOL. RESULTS: There were 502 (43% males) patients with a median age of 38 years and median body mass index 24 kg/m at the time of revision surgery. A new pouch was created in 41% of patients whereas 59% had their original pouch revised and retained. Postoperative mortality was 0% and morbidity was 53%. The short-term anastomotic leak rate was 8%. At a median follow-up of 7 years after redo surgery, 101 (n = 20%) patients had redo IPAA failure. Pelvic sepsis developing after redo ileal pouch surgery was the primary indicator of pouch failure (hazard ratio, 3.691; 95% confidence interval, 2.411-5.699; P < 0.0001). Overall functional outcomes and QOL scores were acceptable. CONCLUSIONS:Patients with a failed ileoanal pouch may be offered redo pouch surgery with a high likelihood of success in terms of function and QOL.
Authors: Olga A Lavryk; Luca Stocchi; Jean H Ashburn; Meagan Costedio; Emre Gorgun; Tracy L Hull; Hermann Kessler; Conor P Delaney Journal: World J Surg Date: 2018-11 Impact factor: 3.352
Authors: G Pellino; D S Keller; G M Sampietro; M Carvello; V Celentano; C Coco; F Colombo; A Geccherle; G Luglio; M Rottoli; M Scarpa; G Sciaudone; G Sica; L Sofo; R Zinicola; S Leone; S Danese; A Spinelli; G Delaini; F Selvaggi Journal: Tech Coloproctol Date: 2020-03-02 Impact factor: 3.781
Authors: O A Lavryk; T L Hull; L C Duraes; L Stocchi; J H Ashburn; D Liska; E Gorgun; H Kessler Journal: Tech Coloproctol Date: 2017-12-28 Impact factor: 3.781
Authors: Erman Aytac; Eren Esen; H Hande Aydinli; Hasan T Kirat; David M Schwartzberg; Feza H Remzi Journal: Pediatr Surg Int Date: 2019-06-05 Impact factor: 1.827
Authors: K T Park; L Sceats; M Dehghan; A W Trickey; A Wren; J J Wong; R Bensen; B N Limketkai; K Keyashian; C Kin Journal: Aliment Pharmacol Ther Date: 2018-06-07 Impact factor: 8.171