PMID- 33826024
OWN - NLM
STAT- MEDLINE
DCOM- 20211022
LR  - 20211022
IS  - 1128-045X (Electronic)
IS  - 1123-6337 (Linking)
VI  - 25
IP  - 11
DP  - 2021 Nov
TI  - D-pouch: a modified ileal J-pouch for patients with ulcerative colitis and 
      familial adenomatous polyposis.
PG  - 1209-1215
LID - 10.1007/s10151-021-02437-4 [doi]
AB  - BACKGROUND: Ileal J-pouch anal anastomosis (J-IPAA) is the standard approach for 
      patients requiring restorative proctocolectomy due to familial adenomatous 
      polyposis (FAP) or ulcerative colitis (UC). To obviate the risk of a J-tip leak, 
      we modified the J-pouch with a D-pouch anal anastomosis (D-IPAA) designed to 
      eliminate the ileal stump. The aim of our study was to evaluate the feasibility, 
      safety and medium-term functional outcomes of D-IPAA. METHODS: A retrospective 
      comparison was made between D-IPAA and J-IPAA constructions after a restorative 
      proctocolectomy. Clinical data were collated between October 2014-March 2018 
      recording operation duration, pouch construction time, pouch volume, 
      intraoperative estimated blood loss, complication rates, readmissions and 
      cumulative length of hospitalization. Continence was assessed at the final visit 
      with the Wexner Cleveland Clinic Score along with the Cleveland Global Quality of 
      Life (CGQL) scale. RESULTS: A total of 97 patients with FAP (n = 28) and UC 
      (n = 69) who had J-IPAA (n = 54) or D-IPAA (n = 43) after proctocolectomy were 
      identified. Patients were well matched with no differences noted in the 
      intraoperative variables between the J- and D-pouch groups. The D-pouch 
      construction time was shorter than that for a standard J-pouch. There was no 
      difference in major or minor complications between groups. A pouch leak developed 
      in each group: a cutaneous fistula from J tip leak in the J-IPAA group and a 
      pouch-vaginal fistula from the IPAA the D-IPAA group. Clinical outcomes (the 
      number of bowel movements) were equivalent in the two groups with the Wexner 
      score significantly improving within each group up to 2.5 years and with 
      improvement in the CGQL after surgery. CONCLUSIONS: The D-pouch construction is 
      safe and feasible for patients with UC and FAP with good functional outcome over 
      the medium term and the potential to reduce the risk of pouch leaks.
CI  - (c) 2021. Springer Nature Switzerland AG.
FAU - Zhang, Y
AU  - Zhang Y
AD  - Department of General Surgery, Renmin Hospital of Wuhan University, Wuhan, China.
FAU - Hu, H
AU  - Hu H
AD  - Department of Colorectal and Anal Surgery of Zhongnan Hospital of Wuhan 
      University, Clinical Center of Intestinal and Colorectal Diseases of Hubei 
      Province, Hubei Key Laboratory of Intestinal and Colorectal Diseases (Zhongnan 
      Hospital of Wuhan University), Colorectal and Anal Disease Research Center of 
      Medical School (Zhongnan Hospital of Wuhan University), Quality Control Center of 
      Colorectal and Anal Surgery of Health Commission of Hubei Province, No. 169, 
      DongHu Road, Wuhan, China.
FAU - Jiang, C
AU  - Jiang C
AD  - Department of Colorectal and Anal Surgery of Zhongnan Hospital of Wuhan 
      University, Clinical Center of Intestinal and Colorectal Diseases of Hubei 
      Province, Hubei Key Laboratory of Intestinal and Colorectal Diseases (Zhongnan 
      Hospital of Wuhan University), Colorectal and Anal Disease Research Center of 
      Medical School (Zhongnan Hospital of Wuhan University), Quality Control Center of 
      Colorectal and Anal Surgery of Health Commission of Hubei Province, No. 169, 
      DongHu Road, Wuhan, China.
FAU - Qian, Q
AU  - Qian Q
AD  - Department of Colorectal and Anal Surgery of Zhongnan Hospital of Wuhan 
      University, Clinical Center of Intestinal and Colorectal Diseases of Hubei 
      Province, Hubei Key Laboratory of Intestinal and Colorectal Diseases (Zhongnan 
      Hospital of Wuhan University), Colorectal and Anal Disease Research Center of 
      Medical School (Zhongnan Hospital of Wuhan University), Quality Control Center of 
      Colorectal and Anal Surgery of Health Commission of Hubei Province, No. 169, 
      DongHu Road, Wuhan, China.
FAU - Ding, Z
AU  - Ding Z
AUID- ORCID: 0000-0002-3950-1772
AD  - Department of Colorectal and Anal Surgery of Zhongnan Hospital of Wuhan 
      University, Clinical Center of Intestinal and Colorectal Diseases of Hubei 
      Province, Hubei Key Laboratory of Intestinal and Colorectal Diseases (Zhongnan 
      Hospital of Wuhan University), Colorectal and Anal Disease Research Center of 
      Medical School (Zhongnan Hospital of Wuhan University), Quality Control Center of 
      Colorectal and Anal Surgery of Health Commission of Hubei Province, No. 169, 
      DongHu Road, Wuhan, China. dingzhao@whu.edu.cn.
LA  - eng
PT  - Journal Article
DEP - 20210407
PL  - Italy
TA  - Tech Coloproctol
JT  - Techniques in coloproctology
JID - 9613614
SB  - IM
MH  - *Adenomatous Polyposis Coli/surgery
MH  - Anastomosis, Surgical
MH  - *Colitis, Ulcerative/surgery
MH  - *Colonic Pouches/adverse effects
MH  - Female
MH  - Humans
MH  - Postoperative Complications/etiology
MH  - *Proctocolectomy, Restorative/adverse effects
MH  - Quality of Life
MH  - Retrospective Studies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Familial adenomatous polyposis (FAP)
OT  - Ileal D-pouch
OT  - Ileal J-pouch
OT  - Ileal pouch-anal anastomosis (IPAA)
OT  - Restorative proctocolectomy
OT  - Ulcerative colitis (UC)
EDAT- 2021/04/08 06:00
MHDA- 2023/02/25 06:00
CRDT- 2021/04/07 12:32
PHST- 2020/10/03 00:00 [received]
PHST- 2021/03/19 00:00 [accepted]
PHST- 2021/04/08 06:00 [pubmed]
PHST- 2023/02/25 06:00 [medline]
PHST- 2021/04/07 12:32 [entrez]
AID - 10.1007/s10151-021-02437-4 [pii]
AID - 10.1007/s10151-021-02437-4 [doi]
PST - ppublish
SO  - Tech Coloproctol. 2021 Nov;25(11):1209-1215. doi: 10.1007/s10151-021-02437-4. 
      Epub 2021 Apr 7.