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| Ileal J Pouch |
| J Pouch, Ileal J Pouch, Ileal j pouch reconstruction, ileal s pouch reconstruction & ileal w pouch reconstruction are also referred as ileal reservoir reconstruction, ileal pouch-anal anastomosis (IPAA), restorative proctocolectomy. Patient with medical conditions of ulcerative colitis or familial polypsis or certain types of colon cancer are subjected to ileal pouch reconstruction. The procedure results in removing colon & most of the rectum, leaving the anal sphincter muscle intact. J-pouch or reservoir is surgically constructed from the small intestine. An opening is made at the bottom of the pouch & sewn or stapled to the anal muscles to restore the intestinal passage. |
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(source: Southern Medical Journal).
More Information (source: Southern Medical Journal).
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12/31/1969 03:59 PM
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Technical Modifications and Improved Results With the Ileal Pouch Anal Anastomosis (Ipaa)
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TECHNICAL MODIFICATIONS AND IMPROVED RESULTS WITH THE ILEAL POUCH ANAL ANASTOMOSIS (IPAA). Schoetz, D. J. Jr. MD Lahey Clinic Medical Center, Burlington, Mass. Coller, J. A. MD Murray, J. J. MD
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12/31/1969 03:59 PM
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Does Laparoscopic-Assisted Ileal-Pouch Anal Anastomosis Reduce the Length of Hospitalization?
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DOES LAPAROSCOPIC-ASSISTED ILEAL-POUCH ANAL ANASTOMOSIS REDUCE THE LENGTH OF HOSPITALIZATION?. Department of Colorectal Surgery, Cleveland Clinic Florida, Ft. Lauderdale. Nogueras, J. J. MD
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12/31/1969 03:59 PM
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Current Controversies in Pouch Surgery
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Restorative proctocolectomy with ileal pouch anal anastomosis has become the most commonly used procedure for elective treatment of patients with mucosal ulcerative colitis and familial adenomatous polyposis. Since its original description, the procedure has been modified in an attempt to obtain optimal functional results with low morbidity and mortality, and yet provide a cure for the disease. These modifications of the technique are discussed in this review, limited to the current points of controversy. We reviewed the current literature describing restorative proctocolectomy with ileal pouch anal anastomosis. The current "hot topics" for debate are transanal mucosectomy with hand-sewn anastomosis versus the double-stapled technique, the use of diverting ileostomy, indeterminate colitis, the role of laparoscopy, and indications for pouch surgery in the elderly. Longer follow-up of patients and increased knowledge and experience with pouch surgery, coupled with active prospective evaluation of the procedure are required to settle these issues. Patients must be fully informed to understand inherent risks of each choice.
(C) 2003 Southern Medical Association
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12/31/1969 03:59 PM
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Four Primary Tumors of Lung, Bladder, Prostate, and Breast in a Male Patient
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We present a very rare case of quadruple cancers in a 65-year-old male patient. It is a case of both synchronous and metachronous primary malignant neoplasms occurring in four different organs. Immunohistochemical stains showed tumor cell nuclei to be negative for p53 over-expression. To our knowledge, this is the first documented case with this combination of primary tumors. The tumors included an adenosquamous cell carcinoma of the lung, transitional cell carcinoma of the urinary bladder, and adenocarcinomas of the prostate and the breast. We also review the medical literature for the possible causes of multiple primary malignant neoplasms.
(C) 2005 Southern Medical Association
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12/31/1969 03:59 PM
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Metabolic, Renal, and Nutritional Consequences of Bariatric Surgery: Implications for the Clinician
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Management of obesity-associated comorbidities costs about $60 billion/year, about 5% of total US healthcare expenditure. Bariatric surgery is the only proven effective weight loss therapy for severely obese patients with a BMI >=35 kg/m2. Bariatric surgery produces long-term weight loss, improves quality of life, and reduces the number of sick days and medication costs. Surgery has a profound effect on the metabolic milieu and nutritional status from the first few days after surgery, even before significant weight loss has been achieved. Metabolic effects of bariatric surgery reduce obesity-related comorbidities like type 2 diabetes, hypertension, metabolic syndrome, and cardiovascular disease risk. Improvement in renal function is seen, but adverse effects like oxalate nephropathy can lead to chronic kidney disease or end-stage renal disease (CKD/ESRD). Surgery can also lead to micronutrient deficiencies, making dietary supplementation necessary. Reduction in insulin resistance and hypertension after surgery makes medication adjustment imperative. Improvement in comorbidities and nutritional deficiencies after bariatric surgery has important clinical implications.
(C) 2010 Southern Medical Association
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