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J Santavirta - One of the best experts on this subject based on the ideXlab platform.
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Lactulose hydrogen and [14C]xylose breath tests in patients with Ileoanal Anastomosis
International Journal of Colorectal Disease, 1991Co-Authors: J SantavirtaAbstract:To study the intestinal bacterial flora and mouth to pouch transit time after Ileoanal Anastomosis, lactulose hydrogen and [14C]xylose breath tests were performed on 19 patients with Ileoanal Anastomosis and J-pouch and 8 patients with conventional ileostomy. Evaluated by the [14C]xylose breath test, patients with Ileoanal Anastomosis and ileal pouch showed no difference in the bacterial flora of the proximal small bowel when compared with ileostomy patients. The lactulose hydrogen breath test showed a significant rise in breath hydrogen, indicating bacterial overgrowth, in 68% of patients with Ileoanal Anastomosis but in none with conventional ileostomy (p
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lactulose hydrogen and 14c xylose breath tests in patients with Ileoanal Anastomosis
International Journal of Colorectal Disease, 1991Co-Authors: J SantavirtaAbstract:To study the intestinal bacterial flora and mouth to pouch transit time after Ileoanal Anastomosis, lactulose hydrogen and [14C]xylose breath tests were performed on 19 patients with Ileoanal Anastomosis and J-pouch and 8 patients with conventional ileostomy. Evaluated by the [14C]xylose breath test, patients with Ileoanal Anastomosis and ileal pouch showed no difference in the bacterial flora of the proximal small bowel when compared with ileostomy patients. The lactulose hydrogen breath test showed a significant rise in breath hydrogen, indicating bacterial overgrowth, in 68% of patients with Ileoanal Anastomosis but in none with conventional ileostomy (p<0.01). It was concluded that this peak in breath hydrogen was produced by the bacteria in the pouch. Thus the lactulose hydrogen breath test can be used to measure mouth to pouch transit time in 2/3 of patients with Ileoanal Anastomosis. Mouth to pouch transit time was 63±9 min and it correlated inversely with stool frequency (p<0.05).
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water and electrolyte balance after Ileoanal Anastomosis
Diseases of The Colon & Rectum, 1991Co-Authors: J Santavirta, A Harmoinen, A L Karvonen, M MatikainenAbstract:Water and electrolyte balance was studied in 30 patients with Ileoanal Anastomosis and J pouch, 10 patients with conventional ileostomy, and nine nonoperated patients with quiescent ulcerative colitis. Serum electrolyte concentrations, daily urinary volume, and daily losses of sodium, potassium, and chloride were measured in all patients. Daily fecal weight and daily losses of sodium and potassium were analyzed in patients with Ileoanal Anastomosis or conventional ileostomy. Serum chloride in patients with Ileoanal Anastomosis was significantly lower (P<0.05) than in those with conventional ileostomy or in nonoperated patients. Daily urinary loss of sodium in nonoperated patients was significantly higher than in patients with Ileoanal Anastomosis(P<0.01) or conventional ileostomy (P<0.05). Daily urinary loss of chloride in patients with Ileoanal Anastomosis was significantly lower (P<0.05) than in nonoperated patients. Daily fecal loss of potassium in patients with Ileoanal Anastomosis was significantly higher (P<0.05) than in those with conventional ileostomy. Daily urinary volume and fecal weight did not differ significantly in patients with Ileoanal Anastomosis or conventional ileostomy. The present study indicates that changes in water and sodium balance after Ileoanal Anastomosis are similar to those after conventional ileostomy but chloride balance is more altered after Ileoanal Anastomosis.
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Water and electrolyte balance after Ileoanal Anastomosis
Diseases of The Colon & Rectum, 1991Co-Authors: J Santavirta, A Harmoinen, A L Karvonen, M MatikainenAbstract:Water and electrolyte balance was studied in 30 patients with Ileoanal Anastomosis and J pouch, 10 patients with conventional ileostomy, and nine nonoperated patients with quiescent ulcerative colitis. Serum electrolyte concentrations, daily urinary volume, and daily losses of sodium, potassium, and chloride were measured in all patients. Daily fecal weight and daily losses of sodium and potassium were analyzed in patients with Ileoanal Anastomosis or conventional ileostomy. Serum chloride in patients with Ileoanal Anastomosis was significantly lower (P
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mucosal morphology and faecal bacteriology after Ileoanal Anastomosis
International Journal of Colorectal Disease, 1991Co-Authors: J Santavirta, J. Mattila, M. Kokki, M MatikainenAbstract:Mucosal morphology and faecal bacteriology were studied in 30 patients with Ileoanal Anastomosis and J-pouch and 10 patients with conventional ileostomy. Patients with Ileoanal Anastomosis had more acute and chronic inflammatory changes on histological examination than patients with conventional ileostomy. Patients with Ileoanal Anastomosis had a greater number of anaerobes and total bacteria and a greater ratio of anaerobes to aerobes in faecal samples than patients with conventional ileostomy. Patients with a history of clinical pouchitis had more acute inflammation than those without. In patients with Ileoanal Anastomosis there was a significant correlation between acute inflammation and number of aerobes and between chronic inflammation and number of anaerobes and total bacterial counts. These observations suggest that bacterial overgrowth in the pouch may be a possible pathogenic factor in inflammatory changes in the mucosa.
M Matikainen - One of the best experts on this subject based on the ideXlab platform.
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water and electrolyte balance after Ileoanal Anastomosis
Diseases of The Colon & Rectum, 1991Co-Authors: J Santavirta, A Harmoinen, A L Karvonen, M MatikainenAbstract:Water and electrolyte balance was studied in 30 patients with Ileoanal Anastomosis and J pouch, 10 patients with conventional ileostomy, and nine nonoperated patients with quiescent ulcerative colitis. Serum electrolyte concentrations, daily urinary volume, and daily losses of sodium, potassium, and chloride were measured in all patients. Daily fecal weight and daily losses of sodium and potassium were analyzed in patients with Ileoanal Anastomosis or conventional ileostomy. Serum chloride in patients with Ileoanal Anastomosis was significantly lower (P<0.05) than in those with conventional ileostomy or in nonoperated patients. Daily urinary loss of sodium in nonoperated patients was significantly higher than in patients with Ileoanal Anastomosis(P<0.01) or conventional ileostomy (P<0.05). Daily urinary loss of chloride in patients with Ileoanal Anastomosis was significantly lower (P<0.05) than in nonoperated patients. Daily fecal loss of potassium in patients with Ileoanal Anastomosis was significantly higher (P<0.05) than in those with conventional ileostomy. Daily urinary volume and fecal weight did not differ significantly in patients with Ileoanal Anastomosis or conventional ileostomy. The present study indicates that changes in water and sodium balance after Ileoanal Anastomosis are similar to those after conventional ileostomy but chloride balance is more altered after Ileoanal Anastomosis.
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Water and electrolyte balance after Ileoanal Anastomosis
Diseases of The Colon & Rectum, 1991Co-Authors: J Santavirta, A Harmoinen, A L Karvonen, M MatikainenAbstract:Water and electrolyte balance was studied in 30 patients with Ileoanal Anastomosis and J pouch, 10 patients with conventional ileostomy, and nine nonoperated patients with quiescent ulcerative colitis. Serum electrolyte concentrations, daily urinary volume, and daily losses of sodium, potassium, and chloride were measured in all patients. Daily fecal weight and daily losses of sodium and potassium were analyzed in patients with Ileoanal Anastomosis or conventional ileostomy. Serum chloride in patients with Ileoanal Anastomosis was significantly lower (P
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mucosal morphology and faecal bacteriology after Ileoanal Anastomosis
International Journal of Colorectal Disease, 1991Co-Authors: J Santavirta, J. Mattila, M. Kokki, M MatikainenAbstract:Mucosal morphology and faecal bacteriology were studied in 30 patients with Ileoanal Anastomosis and J-pouch and 10 patients with conventional ileostomy. Patients with Ileoanal Anastomosis had more acute and chronic inflammatory changes on histological examination than patients with conventional ileostomy. Patients with Ileoanal Anastomosis had a greater number of anaerobes and total bacteria and a greater ratio of anaerobes to aerobes in faecal samples than patients with conventional ileostomy. Patients with a history of clinical pouchitis had more acute inflammation than those without. In patients with Ileoanal Anastomosis there was a significant correlation between acute inflammation and number of aerobes and between chronic inflammation and number of anaerobes and total bacterial counts. These observations suggest that bacterial overgrowth in the pouch may be a possible pathogenic factor in inflammatory changes in the mucosa.
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Ileoanal Anastomosis without covering ileostomy
Diseases of The Colon & Rectum, 1990Co-Authors: M Matikainen, Juhani Santavirta, Kari Matti Hiltunen, G. Bruce ThowAbstract:Ileoanal Anastomosis is usually performed with covering ileostomy. This is primarily done because of fear of pelvic sepsis. Temporary ileostomy may, however, be a source of significant complications. The first 21 patients in the authors clinic were operated upon using covering loop ileostomy in Ileoanal operations. These patients had no anastomotic or pouch complications, but there were complications, especially with the closure of the ileostomy. Therefore, a trial of one-stage operations in Ileoanal Anastomosis was started. Ileoanal Anastomosis without ileostomy was performed on 25 consecutive patients. All the patients were operated upon for ulcerative colitis. There was one patient with pelvic abscess who needed diverting ileostomy. Thus, the early failure rate in patients operated upon without ileostomy was 4 percent. There were many other complications among these patients, but no other relaparotomy was needed. The complication rate was not different in patients operated upon without ileostomy compared with the authors first 21 patients operated upon with ileostomy (60 and 52 percent, respectively). Patients with one-stage operation needed a significantly shorter mean hospital stay than patients with two-stage operation (13.6 days and 25.3 days, respectively;P
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Ileoanal Anastomosis without covering ileostomy
Diseases of The Colon & Rectum, 1990Co-Authors: M Matikainen, Juhani Santavirta, Kari Matti Hiltunen, Bruce G ThowAbstract:Ileoanal Anastomosis is usually performed with covering ileostomy. This is primarily done because of fear of pelvic sepsis. Temporary ileostomy may, however, be a source of significant complications. The first 21 patients in the authors clinic were operated upon using covering loop ileostomy in Ileoanal operations. These patients had no anastomotic or pouch complications, but there were complications, especially with the closure of the ileostomy. Therefore, a trial of one-stage operations in Ileoanal Anastomosis was started. Ileoanal Anastomosis without ileostomy was performed on 25 consecutive patients. All the patients were operated upon for ulcerative colitis. There was one patient with pelvic abscess who needed diverting ileostomy. Thus, the early failure rate in patients operated upon without ileostomy was 4 percent. There were many other complications among these patients, but no other relaparotomy was needed. The complication rate was not different in patients operated upon without ileostomy compared with the authors first 21 patients operated upon with ileostomy (60 and 52 percent, respectively). Patients with one-stage operation needed a significantly shorter mean hospital stay than patients with two-stage operation (13.6 days and 25.3 days, respectively;P<0.001).The use of corticosteroids appears not to be a contraindication for one-stage operation, because there were significantly more patients using corticosteroids in the one-stage group compared with the two-stage group (92 and 62 percent, respectively;P<0.05).
Amanda M Metcalf - One of the best experts on this subject based on the ideXlab platform.
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development of invasive adenocarcinoma following colectomy with Ileoanal Anastomosis for familial polyposis coli report of a case
Diseases of The Colon & Rectum, 1994Co-Authors: Jeff C Hoehner, Amanda M MetcalfAbstract:PURPOSE: Proctocolectomy with Ileoanal Anastomosis has gained increasing acceptance for the prophylactic treatment of patients with familial polyposis coli. Longterm surveillance of the ileal pouch and the pouch-anal Anastomosis has not been emphasized despite concern regarding retained rectal mucosa following the procedure. METHODS: A 34-year-old patient with a strong family history of familial polyposis coli was treated at 14 years of age by single-stage proctocolectomy with straight Ileoanal Anastomosis. Follow-up proctoscopic examinations revealed development of adenomatous changes at the Ileoanal Anastomosis. RESULTS: This report presents a patient with familial polyposis coli who developed invasive adenocarcinoma at the Ileoanal Anastomosis 20 years after proctocolectomy with Ileoanal Anastomosis. CONCLUSIONS: We stress the need for lifelong proctoscopic surveillance in patients with familial polyposis coli treated by proctocolectomy with Ileoanal Anastomosis.
Victor W Fazio - One of the best experts on this subject based on the ideXlab platform.
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anal transitional zone cancer after restorative proctocolectomy and Ileoanal Anastomosis in familial adenomatous polyposis report of two cases
Diseases of The Colon & Rectum, 2003Co-Authors: Feza H Remzi, Terry Gramlich, James M Church, Miriam Preen, Victor W FazioAbstract:PURPOSE: Restorative proctocolectomy with ileal pouch-anal Anastomosis is accepted as the surgical treatment of choice for many patients with familial adenomatous polyposis. The risk of cancer developing in the ileal pouch after this surgery is unknown. Cancer may arise from the ileal pouch after restorative proctocolectomy, but that arising from the anal transitional zone has not been documented in familial adenomatous polyposis. We report two cases of this cancer from the anal transitional zone in patients with familial adenomatous polyposis, with a review of the literature. METHODS: All patients with familial adenomatous polyposis treated with restorative proctocolectomy and ileal pouch-anal Anastomosis in The Cleveland Clinic were included in the study. Patients whose surveillance biopsy of the anal transitional zone revealed invasive adenocarcinoma were studied. RESULTS: Among a total of 146 patients with familial adenomatous polyposis who underwent restorative proctocolectomy and ileal pouch-anal Anastomosis from 1983 to 2001 in our institution, none developed cancer of the anal transitional zone at up to 18 years of follow-up. However, there were two patients, both of whom underwent surgery elsewhere but who were followed up here, who developed invasive adenocarcinoma of the anal transitional zone. In one of them, cancer was diagnosed three years after a double-stapled ileal pouch-anal Anastomosis, whereas in the other, cancer occurred eight years after a straight Ileoanal Anastomosis with mucosectomy. CONCLUSIONS: Cancer may develop in the anal transitional zone after restorative proctocolectomy with ileal pouch-anal Anastomosis for familial adenomatous polyposis. Long-term surveillance of the anal transitional zone needs to be emphasized.
Jeff C Hoehner - One of the best experts on this subject based on the ideXlab platform.
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development of invasive adenocarcinoma following colectomy with Ileoanal Anastomosis for familial polyposis coli report of a case
Diseases of The Colon & Rectum, 1994Co-Authors: Jeff C Hoehner, Amanda M MetcalfAbstract:PURPOSE: Proctocolectomy with Ileoanal Anastomosis has gained increasing acceptance for the prophylactic treatment of patients with familial polyposis coli. Longterm surveillance of the ileal pouch and the pouch-anal Anastomosis has not been emphasized despite concern regarding retained rectal mucosa following the procedure. METHODS: A 34-year-old patient with a strong family history of familial polyposis coli was treated at 14 years of age by single-stage proctocolectomy with straight Ileoanal Anastomosis. Follow-up proctoscopic examinations revealed development of adenomatous changes at the Ileoanal Anastomosis. RESULTS: This report presents a patient with familial polyposis coli who developed invasive adenocarcinoma at the Ileoanal Anastomosis 20 years after proctocolectomy with Ileoanal Anastomosis. CONCLUSIONS: We stress the need for lifelong proctoscopic surveillance in patients with familial polyposis coli treated by proctocolectomy with Ileoanal Anastomosis.
