uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
Can a failed ileal pouch anal anastomosis be left in situ?
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Genetics and Pathology.
Show others and affiliations
2007 (English)In: Colorectal Disease, ISSN 1462-8910, E-ISSN 1463-1318, Vol. 9, no 6, 503-508 p.Article in journal (Refereed) Published
Abstract [en]

Objective: Failure after ileal pouch-anal anastomosis (IPAA) is reported with a frequency of 10-20%. The failed IPAA can be excised or defunctioned. Indications for excision and further management of an indefinitely diverted pouch are poorly described. The aim of the present investigation was to investigate pouch-related problems and the histopathological pattern of the pouch mucosa in this group of patients. Method: In a cohort of 620 patients having IPAA with a median follow-upof 14 years, 56 patients with failure were identified. The patients with defunctioned pouches were assessed with regard to pouch-related problems and endoscopy with biopsies was performed. Biopsies were stained with haematoxylin-eosin, PAS for neutral mucins and Alcian blue/high iron diamine for sialomucins/sulphomucins. Morphological changes were grouped into three types modified according to Veress and assessed for dysplasia. Results: Twenty-two patients withan indefinitely diverted pouch were found. The follow-up time after surgery for failure was 10 years. Thirteen patients completed the follow-up. Except for two patients with pelvic/perineal pain, there were no clinical problems. The majority of patients displayed mild to moderate macroscopic signs of inflammation. Morphologically, findings ranged from a preserved mucosal pattern to intense inflammatory reaction. No case of dysplasia or carcinoma was found. Conclusion: Most patients with an indefinitely diverted pouch had no complaints regarding the pouch. There was no case of dysplasia. Indefinite diversion may be preferable to pouch excision, especially given the associated morbidity.

Place, publisher, year, edition, pages
2007. Vol. 9, no 6, 503-508 p.
Keyword [en]
Clinical management, Failure, IPAA, Morphological changes
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-13798DOI: 10.1111/j.1463-1318.2007.01308.xISI: 000247262500008PubMedID: 17573744OAI: oai:DiVA.org:uu-13798DiVA: diva2:41568
Available from: 2008-01-25 Created: 2008-01-25 Last updated: 2011-01-31Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed
By organisation
Department of Genetics and Pathology
In the same journal
Colorectal Disease
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 158 hits
ReferencesLink to record
Permanent link

Direct link