Annals of Colorectal Research Annals of Colorectal Research Ann Colorectal Res http://www.colorectalresearch.com 2322-5262 2322-5289 10.5812/acr. en jalali 2017 6 26 gregorian 2017 6 26 4 4
en 10.17795/acr-34169 Pouch Salvage Surgery for Treatment of Colitis and Familial Adenomatous Polyposis: Report of Five Cases Pouch Salvage Surgery for Treatment of Colitis and Familial Adenomatous Polyposis: Report of Five Cases case-report case-report Conclusions

After performing pouch salvage operation, pouch function was acceptable in all patients and we could close ileostomies of all of them.

Case Presentation

In this report, five patients were introduced, who underwent pouch salvage surgery after RPC/IPAA surgery failure. Two of the patients were male and three were female and the relevant age range was 16 to 41. Initially, RPC/IPAA surgery was performed on these five patients. Four of the patients underwent RPC/IPAA surgery as a result of ulcerative colitis and, one of the patients as a result of familial adenomatous polyposis. However, due to pouch failure from the RPC/IPAA surgery, pouch-salvage surgery was performed on each of these five patients. Two of the patients underwent pouch-salvage surgery due to infection and pouch fistula, and the other three underwent this surgery due to the remaining rectal stump, anastomosis stenosis and pouch dysfunction. The average time for when pouch-salvage surgery was performed was 3.5 years (three months to five years) after the initial operation and the patients were under follow-up care for two to seven years.

Introduction

The restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis (IPAA) is currently the preferred surgical method for most patients with ulcerative colitis and familial adenomatous polyposis and sometimes, functional bowel diseases. Infection around the pouch, remaining rectal stump, stricture at anastomosis site, pouch dysfunction and refractory pouchitis can lead to pouch failure. Pouch salvage surgery could prevent pouch failure in some cases.

Conclusions

After performing pouch salvage operation, pouch function was acceptable in all patients and we could close ileostomies of all of them.

Case Presentation

In this report, five patients were introduced, who underwent pouch salvage surgery after RPC/IPAA surgery failure. Two of the patients were male and three were female and the relevant age range was 16 to 41. Initially, RPC/IPAA surgery was performed on these five patients. Four of the patients underwent RPC/IPAA surgery as a result of ulcerative colitis and, one of the patients as a result of familial adenomatous polyposis. However, due to pouch failure from the RPC/IPAA surgery, pouch-salvage surgery was performed on each of these five patients. Two of the patients underwent pouch-salvage surgery due to infection and pouch fistula, and the other three underwent this surgery due to the remaining rectal stump, anastomosis stenosis and pouch dysfunction. The average time for when pouch-salvage surgery was performed was 3.5 years (three months to five years) after the initial operation and the patients were under follow-up care for two to seven years.

Introduction

The restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis (IPAA) is currently the preferred surgical method for most patients with ulcerative colitis and familial adenomatous polyposis and sometimes, functional bowel diseases. Infection around the pouch, remaining rectal stump, stricture at anastomosis site, pouch dysfunction and refractory pouchitis can lead to pouch failure. Pouch salvage surgery could prevent pouch failure in some cases.

Familial Adenomatous Polyposis;Ilioanal Pouch;Sepsis;Total Proctocolectomy;Ulcerative Colitis Familial Adenomatous Polyposis;Ilioanal Pouch;Sepsis;Total Proctocolectomy;Ulcerative Colitis http://www.colorectalresearch.com/index.php?page=article&article_id=34169 Saeed Derakhshani Saeed Derakhshani Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Arash Mohammadi Tofigh Arash Mohammadi Tofigh Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Behzad Nemati Honar Behzad Nemati Honar Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Gholamhossein Hayatollah Gholamhossein Hayatollah Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel: +98-9127240298 Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel: +98-9127240298 Maryam Derakhshani Maryam Derakhshani University of British Colombia, Okanagan, BC, Canada University of British Colombia, Okanagan, BC, Canada