Indications, functional and quality of life outcomes of new
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Salvage of the existing ileal pouch is favored during re-do ileal pouch anal anastomosis if the pouch is not damaged after pelvic dissection and there are no other mechanical reasons that may necessitate the construction of a new pouch. Excision of the existing pouch may be associated with some concerns for short-bowel syndrome and poor functional outcomes.

This study aimed to report indications and compare functional and quality of life outcomes of new pouch creation versus salvage of the existing pouch during re-do ileal pouch anal anastomosis.

Patients who underwent re-do ileal pouch anal anastomosis were included. The reasons for pouch excision and new pouch creation were reported. Perioperative, functional outcomes and quality of life were compared between patients who had a creation of a new pouch versus salvage of the existing pouch. A total of 105 patients with re-do ileal pouch anal anastomosis (new pouch, n = 63) were included.

- The most common indications for a new pouch creation were chronic pelvic infections that compromised the integrity and viability of the existing pouch and small pouch.

- No patient developed the short-bowel syndrome. The number of bowel movements, daily restrictions, and Cleveland Global Quality of Life score scores were similar between the 2 groups.

- Day-time seepage, daytime, and night-time pad usage were more common after new pouch creation. Two-year pouch survival rates were comparable.

In particular, new pouch creation can be safely performed at the time of re-do ileal pouch anal anastomosis. It provides acceptable functional and quality of life outcomes if existing pouch salvage is not feasible.

Surgery
Source: https://doi.org/10.1016/j.surg.2021.06.026
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