Intestinal Research

Yuichiro Yokoyama

1 Article

IBD

Risk factors for non-reaching of ileal pouch to the anus in laparoscopic restorative proctocolectomy with handsewn anastomosis for ulcerative colitis: Shigenobu Emoto, Keisuke Hata, Hiroaki Nozawa, Kazushige Kawai, Toshiaki Tanaka, Takeshi Nishikawa, Yasutaka Shuno, Kazuhito Sasaki, Manabu Kaneko, Koji Murono, Yuuki Iida, Hiroaki Ishii, Yuichiro Yokoyama, Hiroyuki Anzai, Hirofumi Sonoda, Soichiro Ishihara; Intest Res 2022;20(3):313-320. Published online March 12, 2021; DOI: https://doi.org/10.5217/ir.2020.00158

Background/Aims
Restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis and handsewn anastomosis for ulcerative colitis requires pulling down of the ileal pouch into the pelvis, which can be technically challenging. We examined risk factors for the pouch not reaching the anus.
Methods
Clinical records of 62 consecutive patients who were scheduled to undergo RPC with handsewn anastomosis at the University of Tokyo Hospital during 1989–2019 were reviewed. Risk factors for non-reaching were analyzed in patients in whom hand sewing was abandoned for stapled anastomosis because of nonreaching. Risk factors for non-reaching in laparoscopic RPC were separately analyzed. Anatomical indicators obtained from presurgical computed tomography (CT) were also evaluated.
Results
Thirty-seven of 62 cases underwent laparoscopic procedures. In 6 cases (9.7%), handsewn anastomosis was changed to stapled anastomosis because of non-reaching. Male sex and a laparoscopic approach were independent risk factors of non-reaching. Distance between the terminal of the superior mesenteric artery (SMA) ileal branch and the anus > 11 cm was a risk factor for non-reaching.
Conclusions
Laparoscopic RPC with handsewn anastomosis may limit extension and induction of the ileal pouch into the anus. Preoperative CT measurement from the terminal SMA to the anus may be useful for predicting non-reaching.

Citations

Citations to this article as recorded by

Preoperative Simulation of Ileal Pouch–Anal Anastomosis in Patients With Ulcerative Colitis Using a 3-Dimensional Printed Model
Shota Yokose, Koji Murono, Hiroaki Nozawa, Kazuhito Sasaki, Shigenobu Emoto, Hiroyuki Matsuzaki, Yuichiro Yokoyama, Shinya Abe, Yuzo Nagai, Yuichiro Yoshioka, Takahide Shinagawa, Hirofumi Sonoda, Shin Murai, Koichi Komatsu, Soichiro Ishihara
Inflammatory Bowel Diseases.2023; 29(12): 1865. CrossRef
Preoperative Computed Tomography Indices Predict Non-reach Prior to Ileal Pouch-Anal Anastomosis
Evan D. Adams, Charlotte A Lansky, Cindy E. Kallman, Karen N. Zaghiyan, Phillip R. Fleshner
Diseases of the Colon & Rectum.2023;[Epub] CrossRef
Laparoscopic vs open restorative proctectomy after total abdominal colectomy for ulcerative colitis or familial adenomatous polyposis
Hiroaki Nozawa, Keisuke Hata, Kazuhito Sasaki, Koji Murono, Kazushige Kawai, Shigenobu Emoto, Soichiro Ishihara
Langenbeck's Archives of Surgery.2022; 407(4): 1605. CrossRef
Recent Advance in the Management of Dysplasia in the Ulcerative Colitis
Dong-Hoon Yang
Journal of Digestive Cancer Reports.2021; 9(2): 50. CrossRef

5,454 View
508 Download
3 Web of Science
4 Crossref

Author index