Annals of Coloproctology

Display

Sort by :

Original Articles

Benign GI diease,Benign diesease & IBD,Rare disease & stoma

Geographical Variation in the Use of Diverting Loop Ileostomy in Australia and New Zealand Colorectal Surgeons: David A. Clark, Bree Stephensen, Aleksandra Edmundson, Daniel Steffens, Michael Solomon; Ann Coloproctol. 2021;37(5):337-345. Published online September 18, 2020; DOI: https://doi.org/10.3393/ac.2020.09.14.1

5,351 View
75 Download
9 Web of Science
10 Citations

Purpose
Anastomotic leak (AL) after a low pelvic anastomosis is a devastating complication, with short- and long-term morbidity and increased mortality. Surgeons may employ various adjuncts in an attempt to reduce AL rates or mitigate their impact. These include the use of temporary diverting ileostomy (TDI), transanal or rectal tubes and pelvic drains. This questionnaire evaluates the preferences and routine use of these adjuncts in Australasian colorectal surgeons.
Methods
A cross-sectional survey was administered to Australian and New Zealand colorectal surgeons on September 20, 2018. The study survey consisted of 15 questions exploring basic demographics and the number of rectal resections and ileal pouches performed in 12 months, along with the surgeon’s preference for the use of diverting stomas, rectal tubes, and pelvic drains.
Results
There were 90 respondents to the survey (31.6%). Surgeons in Western Australia (71.4%) were more likely to use a mandatory TDI in colorectal extraperitoneal anastomoses than surgeons in Queensland (14.3%). South Australian surgeons are more likely to employ a mandatory TDI (100%) for ileal pouches than Queensland surgeons (42.9%). Rectal tubes are not commonly utilized (40.0% never use them), and pelvic drains are (45.6% in all cases). Surgeons consider a median AL rate of 15% was felt to justify the use of a TDI in low pelvic anastomoses and a median AL rate of 10% for ileal pouches
Conclusion
There is considerable geographical variation in colorectal surgical practice throughout Australia and New Zealand. While surgeons interrogate the same literature, there are presumably other factors that see translation into variations in clinical practice.

Citations

Citations to this article as recorded by

Interrupted Ileostomy Tube vs. traditional diverting ileostomy in low rectal cancer: a propensity score–matched retrospective study
Haiyuan Zhao, Yilin Liu, Yan Jin, Yang Li, Daping Jiang, Guohai Zhao, Jun Zhao
Mini-invasive Surgery.2026;[Epub] CrossRef
Predictors of pouch failure and quality of life following ileal pouch‐anal anastomosis for ulcerative colitis: a retrospective multicenter study
Ahmet Rencuzogullari, Cihangir Akyol, Ismail Hamzaoglu, Tahsin Colak, Tayfun Karahasanoglu, Ugur Sungurtekin, Sezai Leventoglu, Ersin Ozturk, Mustafa Ali Korkut, Selman Sokmen
ANZ Journal of Surgery.2025; 95(3): 457. CrossRef
Drain fluid iodine as a biomarker of anastomotic leak after low anterior resection in patients undergoing Gastrografin rectal tube flushes and omission of a diverting ileostomy: The GUSH study
David A. Clark, Karen Dobeli, Darren Allen, Brett McWhinney, Michael Lonne, Aleksandra Edmundson
Colorectal Disease.2025;[Epub] CrossRef
Feasibility of triple assessment of the anastomosis using an anastomotic checklist
Madeleine Louise Kelly, Amy Cao, Ruben Rajan, David A Clark
ANZ Journal of Surgery.2024; 94(10): 1812. CrossRef
Drain fluid amylase as a biomarker for the detection of anastomotic leakage after rectal resection without a diverting ileostomy
David A. Clark, Aleksandra Edmundson, Daniel Steffens, Craig Harris, Andrew Stevenson, Michael Solomon
ANZ Journal of Surgery.2022; 92(4): 813. CrossRef
Surgical management and long‐term functional outcomes after anastomotic leak in patients undergoing minimally invasive restorative rectal resection and without a diverting ileostomy
Tony McGiffin, David A. Clark, Aleks Edmundson, Daniel Steffens, Andrew Stevenson, Michael Solomon
ANZ Journal of Surgery.2022; 92(4): 806. CrossRef
Does an ileostomy cover the surgeon or the anastomosis?
David A. Clark, Andrew Stevenson, John Lumley, Damien Petersen, Craig Harris, Daniel Steffens, Michael Solomon
ANZ Journal of Surgery.2022; 92(1-2): 19. CrossRef
Risk taking propensity: Nurse, surgeon and patient preferences for diverting ileostomy
Ian Mackay, David A. Clark, James Nicholson, Aleks Edmundson, Daniel Steffens, Michael Solomon
Colorectal Disease.2022; 24(9): 1073. CrossRef
Multicenter Study of Drain Fluid Amylase as a Biomarker for the Detection of Anastomotic Leakage After Ileal Pouch Surgery Without a Diverting Ileostomy
David A. Clark, • Aleksandra Edmundson, Daniel Steffens, Graham Radford-Smith, Michael Solomon
Diseases of the Colon & Rectum.2022; 65(11): 1335. CrossRef
An umbrella systematic review of drain fluid analysis in colorectal surgery for the detection of anastomotic leak: Not yet ready to translate research studies into clinical practice
David A. Clark, Daniel Steffens, Michael Solomon
Colorectal Disease.2021; 23(11): 2795. CrossRef

Benign GI diease, Inflammatory bowel disease

Short-term Outcomes of Elective 2-Stage Restorative Proctocolectomy for Ulcerative Colitis in Korea: Does Laparoscopy Have Benefits?: Jun Woo Bong, Yong Sik Yoon, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim; Ann Coloproctol. 2020;36(1):41-47. Published online February 29, 2020; DOI: https://doi.org/10.3393/ac.2019.03.29

5,903 View
90 Download
5 Web of Science
4 Citations

Abstract PDF

Purpose
This study aimed to compare the short-term outcomes of the open and laparoscopic approaches to 2-stage restorative proctocolectomy (RPC) for Korean patients with ulcerative colitis (UC).
Methods
We retrospectively analyzed the medical records of 73 patients with UC who underwent elective RPC between 2009 and 2016. Patient characteristics, operative details, and postoperative complications within 30 days were compared between the open and laparoscopic groups.
Results
There were 26 cases (36%) in the laparoscopic group, which had a lower mean body mass index (P = 0.025), faster mean time to recovery of bowel function (P = 0.004), less intraoperative blood loss (P = 0.004), and less pain on the first and seventh postoperative days (P = 0.029 and P = 0.027, respectively) compared to open group. There were no deaths, and the overall complication rate was 43.8%. There was no between-group difference in the overall complication rate; however, postoperative ileus was more frequent in the open group (27.7% vs. 7.7%, P = 0.043). Current smoking (odds ratio [OR], 44.4; P = 0.003) and open surgery (OR, 5.4; P = 0.014) were the independent risk factors for postoperative complications after RPC.
Conclusion
Laparoscopic RPC was associated with acceptable morbidity and faster recovery than the open approach. The laparoscopic approach is a feasible and safe option for surgical treatment for UC in selective cases.

Citations

Citations to this article as recorded by

ECCO Guidelines on Therapeutics in Ulcerative Colitis: Surgical Treatment
Michel Adamina, Peter Kienle, María Chaparro, Bram Verstockt, Silvia Minozzi, Mariangela Allocca, Raja Atreya, Nicolas Avellaneda, Manuel Barreiro-De Acosta, Robert Battat, Dominik Bettenworth, Irina Blumenstein, Steven R Brown, John P Burke, Flavio Capri
Journal of Crohn's and Colitis.2026;[Epub] CrossRef
Patient-reported Outcome Measures in Ileoanal Pouch Surgery: a Systematic Review
Zakary Ismail Warsop, Carlo Alberto Manzo, Natalie Yu, Bilal Yusuf, Christos Kontovounisios, Valerio Celentano
Journal of Crohn's and Colitis.2024; 18(3): 479. CrossRef
Creation of an institutional preoperative checklist to support clinical risk assessment in patients with ulcerative colitis (UC) considering ileoanal pouch surgery
Bruno Augusto Alves Martins, Amira Shamsiddinova, Manal Mubarak Alquaimi, Guy Worley, Phil Tozer, Kapil Sahnan, Zarah Perry-Woodford, Ailsa Hart, Naila Arebi, Manmeet Matharoo, Janindra Warusavitarne, Omar Faiz
Frontline Gastroenterology.2024; 15(3): 203. CrossRef
Benefits of Elective Laparoscopic 2-Stage Restorative Proctocolectomy for Ulcerative Colitis in Korea
Sun Min Park, Won-Kyung Kang
Annals of Coloproctology.2020; 36(1): 3. CrossRef

Risk Factors of Pouch Failure after a Restorative Proctocolectomy.: Shin, Ui Sup , Yu, Chang Sik , Kim, Dae Dong , Yoon, Sang Nam , Kim, Jin Cheon; J Korean Soc Coloproctol. 2008;24(4):252-259.; DOI: https://doi.org/10.3393/jksc.2008.24.4.252

2,715 View
15 Download
1 Citations

Abstract PDF

PURPOSE
The aim of this study was to analyze the risk factors of pouch failure after a restorative proctocolectomy.
METHODS
A restorative proctocolectomy was performed in 169 patients between November 1989 and May 2007. A retrospective review was done for postoperative complications and follow-up results of pouch failure, and the risk factors of pouch failure were analyzed. Pouch failure was defined as having occurred when a permanent ileostomy was constructed, regardless of pouch removal. The median follow-up was 48 (3~155) months.
RESULTS
Among the 169 cases, 86 cases involved ulcerative colitis (UC group), 70 cases involved familial adenomatous polyposis or attenuated adenomatous polyposis coli (FAP group), and the remaining 13 involved hereditary nonpolyposis colorectal cancer or synchronous colon and rectal caner (CRC group). The sex ratios and the incidences of comorbidity were not significantly different between the groups, but the mean ages were. Complications occurred in 61 patients (36.1%): pelvic sepsis (28 cases), pouchitis (23 cases), desmoid tumor (12 cases), wound infection (10 cases), and anastomosis stricture (4 cases). The 5-year cumulative rate of pouch failure was 9.8%. Presence of a desmoid tumor, pelvic sepsis, and anastomosis stricture were risk factors of pouch failure.
CONCLUSIONS
The cumulative pouch failure rate after a restorative proctocolectomy was 9.8% for 5 years, and pouch failure was associated with the presence of a desmoid tumor, pelvic sepsis, and anastomosis stricture.

Citations

Citations to this article as recorded by

Factors affecting pouch-related outcomes after restorative proctocolectomy
Gyoung Tae Noh, Jeonghee Han, Min Soo Cho, Hyuk Hur, Byung Soh Min, Kang Young Lee, Nam Kyu Kim, Emiko Mizoguchi
PLOS ONE.2017; 12(10): e0186596. CrossRef

The Significance of Diverting Ileostomy during Restorative Proctocolectomy.: Hong, Dong Hyun , Yu, Chang Sik , NamGung, Hwan , Cho, Young Kyu , Kim, Hee Cheol , Kim, Jin Cheon; J Korean Soc Coloproctol. 2002;18(6):386-389.

1,641 View
37 Download

Abstract PDF: PURPOSE
Restorative proctocolectomy (RP) is a standard surgery in patients with ulcerative colitis and familial adenomatous polyposis. Usually, diverting ileostomy is performed to protect an ileoanal anastomosis with RP. However, there are many controversies whether diverting ileostomy might urgently be needed. This study was performed to compare postoperative complications after RP with or without diverting ileostomy.
METHODS
Between July 1994 and June 2001, 77 (M : F= 45 : 32) patients underwent RP. The indication criteria for diverting ileostomy included tension at the anastomosis, positive leakage test, compromised blood flow in the ileal pouch, long-term and high-dose steroid use, and severe rectal inflammation in ulcerative colitis patients.
RESULTS
Histopathologic diagnoses revealed 45 ulcerative colitis, 23 familial adenomatous polyposis, 5 rectal cancer, and 4 hereditary nonpolyposis colorectal cancer. Diverting ileostomies were performed in 40 patients (51.9%) and closed approximately 4 months later. Fourty eight complications were present in 32 patients. There was no perioperative death. There was no difference in perioperative outcome, morbidity or functional status between patients with and without ileostomy. However, in ulcerative colitis patients, anastomosis leakage was more frequent in patients without ileostomy.
CONCLUSIONS
Restorative proctocolectomy can be safely performed without diverting ileostomy in most cases of RP. However, diverting ileostomy may reduce anastomosis leakage in patients with ulcerative colitis.

The P-pouch: a New Ileal Reservoir Used in Restorative Proctocolectomy.: Lee, Joobong , Yun, Sungpil , Oh, Nahmgun; J Korean Soc Coloproctol. 2006;22(6):363-370.

1,384 View
5 Download

Abstract PDF: PURPOSE
To evaluate the effectiveness of a P-pouch configuration with a reservoir and recycled segment in restorative proctocolectomy.
METHODS
There were 11 patients who underwent the P-pouch procedure. They were compared with healthy eight-control subjects. The P-pouch configuration was constructed using one firing of a 10 cm GIA stapler to form a 12-cm reservoir. Following that, the distal ileum (15+/-0.5 cm) was anastomosed to the proximal portion of the pouch. Pouch function was studied 23.3+/-4.4 months after ileostomy closure. We measured the frequency and amount of stool. The postprandial plasma peptide YY (PYY) response and the scintigraphic studies using 99m-Tc sulfur colloid were used to study transit.
RESULTS
In the patient group, daily stool frequency and volume were 5.2+/-0.3 and 423.5+/-23.7 g, respectively. Stool seepage and pouchitis occurred in 45.5 % and 9.1%. In contrast to other pouch procedures, the postprandial increment of plasma PYY was similar the P-pouch patients and healthy controls (P>0.05). The integrated increment of plasma PYY for 180 minutes following meals was also not decreased in 9-pouch patient group compared with the healthy controls (1,050.0+/-127.8 pmol/l vs. 1146.0+/-150.0 pmol/l, P>0.05). Small intestinal transit time for healthy controls and the patient group averaged 89+/-21 and 117+/-12 minutes (P>0.05). The capacity of the ileal pouch was 372+/-22 ml, and the efficiency of ileal reservoir evacuation was 76 %.
CONCLUSIONS
The P-pouch is a new and improved simple modification of the well-established J-pouch procedure, constructed using a single firing of a GIA stapler.

The Correlation between Quality of Life and Functional Outcome after Restorative Proctocolectomy and Ileal Pouch-Anal Anastomosis.: Yoon, Eyi Sang , Lee, Kil Yeon , Lee, Suk Hwan , Yoon, Choong; J Korean Soc Coloproctol. 2006;22(1):15-23.

1,540 View
4 Download

Abstract PDF: PURPOSE
The restorative proctocolectomy (RP) and ileal pouch-anal anastomosis (IPAA) has been accepted as the operation of choice for chronic ulcerative colitis (CUC) and familial adenomatous polyposis (FAP). However, much is still unknown about the functional outcome and the quality of life (QoL) in patients undergoing RP. The aims of this study were to evaluate the functional outcome and the QoL in patients undergoing RP and to assess the correlation between functional outcome and QoL.
METHODS
The medical records of 20 patients who had undergone a RP for CUC (n=11) and FAP (n=9) from January 1993 to December 2003 were reviewed. The QoL was evaluated with the Korean version of Short Form 36 (SF-36) by telephone interview. The functional outcome was assessed by means of the Global Assessment of Function Scale (GAFS). The QoL of patients was compared with that of the general population matched for age and gender (n=107) with including the 7 men, the median age will be thought to be that of the 13 women.
RESULTS
There were 7 men (35%) and 13 women (65%), and the median age was 46 years. The QoL in patients undergoing RP was comparable to that of the healthy general population on all scales. The Physical Component Summary (PCS) was correlated significantly with the daytime and the nighttime incontinence (P<0.01). The Mental Component Summary (MCS) was correlated significantly with the daytime and the nighttime incontinence and the daytime bowel movement (P<0.05).
CONCLUSIONS
This study demonstrates that the QoL in patients undergoing RP is excellent and that the daytime incon tinence and the nighttime incontinence are significant factor influencing the QoL.

Comparison of the Result of Restorative Proctocolectomy and Ileal Pouch-anal Anastomosis in Familial Adenomatous Polyposis and Ulcerative Colitis.: Park, Sun Jin , Lee, Gil Yeon , Lee, Kee Hyung , Koh, Suck Hwan , Hong, Sung Wha , Oh, Soo Myung , Yoon, Choong; J Korean Soc Coloproctol. 2001;17(4):171-176.

1,881 View
12 Download

Abstract PDF: PURPOSE
The aim of this study was to compare the early postoperative results and the long-term outcome of restorative proctocolectomy and ileal pouch-anal anastomosis (IPAA) in familial adenomatous polyposis (FAP) and ulcerative colitis (UC).
METHODS
Thirty patients that underwent IPAA for either FAP (14 patients) or UC (16 patients) at Kyung-Hee University Hospital between January 1987 and December 1999 were studied retrospectively. Either handsewn or stapled anastomosis technique was used in IPAA. Most patients (12 patients in FAP, 16 patients in UC) had a two-stage operation with temporary diverting loop ileostomy and two patients with FAP had a one-stage operation without temporary ileostomy.
RESULTS
One patient in the UC group died from sepsis after operation (n=16, 6.25%), but no patients in the FAP group died. Overall operative complications appeared in two patients (14.3%) and four patients (25%) with FAP and UC, respectively. At follow-up (mean, 47.3 months), pouchitis was developed in four patients with UC, but no patients with FAP. The mean daytime stool frequency was 4.5 stools per day in FAP patients and 5.8 stools per day in UC patients (P=0.031), but night-time stool frequency was similar between two groups (1.2 and 1.4 in FAP and UC, respectively; P>0.05). Daytime fecal incontinence was noticed in two patients (14.3%) with FAP and four patients (26.7%) with UC. Night-time fecal incontinence was noticed in three patients (21.4%) with FAP and six patients (40.0%) with UC.
CONCLUSIONS
FAP patients tolerated the operation better and had less long-term disability than did UC patients. This suggested that the long-term outcome of IPAA procedure may depend on the primary disease rather than the procedure itself.

First
Prev
Page of 1
Next
Last

Search