Abstract
Restorative proctocolectomy with ileal pouch-anal anastomosis (RP/IPAA) is the procedure of choice for patients with ulcerative colitis and selected patients with familial adenomatous polyposis [1, 2] (Fig. 20.1). J-pouch is the most commonly used reservoir because it is easier to construct compared with S or W pouches [2] (Fig. 20.2). Stapled IPAA has become the preferred approach with good long-term functional outcomes and quality of life (QOL) over a hand-sewn anastomosis [3] (Fig. 20.3). In patients with toxic megacolon or severe fulminant colitis, RP/IPAA is performed in multistages including subtotal colectomy and end ileostomy and then in about 6 months completion proctectomy and IPAA with/without diverting ileostomy. Ileostomy is closed in 3 months following IPAA after checking integrity of pouch and IPAA using water-contrasted enema.
Keywords
- Familial Adenomatous Polyposis
- Restorative Proctocolectomy
- Pelvic Sepsis
- Pouch Failure
- Reoperative Surgery
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Kirat, H.T., Remzi, F.H. (2012). Failing Pouch. In: Brown, S., Hartley, J., Hill, J., Scott, N., Williams, J. (eds) Contemporary Coloproctology. Springer, London. https://doi.org/10.1007/978-0-85729-889-8_20
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DOI: https://doi.org/10.1007/978-0-85729-889-8_20
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