ArticleTechniques in coloproctology2018
Clinical value of pouchogram prior to ileostomy closure after ileal pouch anal anastomosis.
Article in Techniques in coloproctology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Preoperative anastomotic evaluation prior to ileostomy closure: A 5-year UK survey, systematic review, and meta-analysis.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2025Pooled it
- Fluorescence perfusion assessment of vascular ligation during ileal pouch-anal anastomosis.Techniques in coloproctology · 2023Article
- Disease Monitoring of the Ileoanal Pouch: How to Utilize Biomarkers, Imaging, and Pouchoscopy.Current gastroenterology reports · 2022Review
- Dealing with Complications of Colorectal Surgery Using the Transanal Approach-When and How?Clinics in colon and rectal surgery · 2022Review
- Pouchitis: insight into the pathogenesis and clinical aspects.American journal of translational research · 2022Review
- Ileal Pouch-anal Anastomosis Complications and Pouch Failure: A systematic review and meta-analysis.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2021Article
- Inflammatory bowel disease position statement of the Italian Society of Colorectal Surgery (SICCR): ulcerative colitis.Techniques in coloproctology · 2020Review
- Endo-sponge Assisted Early Surgical Closure of Ileal Pouch-anal Anastomotic Leakage Preserves Long-term Function: A Cohort Study.Journal of Crohn's & colitis · 2019Article
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn patients who undergo restorative proctocoletomy (RPC) a pouchogram is often used to assess the integrity of the ileal pouch-anal anastomosis (IPAA) before closing the covering ileostomy. There are no good data to support this practice. The aim of the study was to investigate whether contrast pouchography was clinically useful after RPC.
methodsWe conducted a retrospective study of patients who had undergone RPC with a covering ileostomy between September 2013 and September 2015.
results61 patients were included. 7 (11%) presented with anastomotic leak and 2 (3%) with pelvic collection, detected on cross-sectional imaging for early postoperative symptoms. In the remaining 52 patients, without immediate postoperative complications, pouchography was performed at a median of 14 weeks (range 7-71 weeks) after RPC. Each patient also underwent examination under anaesthesia (EUA) to assess the integrity of the IPAA on the day of the ileostomy closure. One asymptomatic patient (2%) had an anastomotic leak demonstrated on pouchogram which was subsequently confirmed at EUA. Two patients (3%) with a normal pouchogram, 1 symptomatic and 1 asymptomatic, subsequently had an anastomotic leak demonstrated at EUA.
conclusionsPouchogram has a low sensitivity in identifying anastomotic leak before ileostomy reversal in patients after RPC and only rarely changes management. In our series it identified the diagnosis of anastomotic leak in only 1 patient and gave false reassurance in two others. Complications are more frequently detected by clinical history and formal EUA before ileostomy closure.
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