Guide to Endoscopy of the Ileo-anal Pouch Following Restorative Proctocolectomy with Ileal Pouch-anal Anastomosis; Indications, Technique, and Management of Common Findings

TY - JOUR

T1 - Guide to Endoscopy of the Ileo-anal Pouch Following Restorative Proctocolectomy with Ileal Pouch-anal Anastomosis; Indications, Technique, and Management of Common Findings

AU - McLaughlin, Simon D.

AU - Clark, Susan K.

AU - Thomas-Gibson, Siwon

AU - Tekkis, Paris P.

AU - Ciclitira, Paul J.

AU - Nicholls, R. John

PY - 2009

Y1 - 2009

N2 - Restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis is the surgical procedure of choice for patients with ulcerative colitis (UC). It is also performed in selected patients with familial adenomatous polyposis (FAP). A significant proportion of patients will develop pouch dysfunction. Flexible pouchoscopy is the most important initial investigation in patients with dysfunction. It is also important in UC and FAP surveillance. The aim is to provide gastroenterologists with a clear Understanding of the technique, indications, and diagnostic pitfalls when investigating RPC patients with flexible pouchoscopy. Flexible pouchoscopy for the investigation of RPC patients with pouch dysfunction has a high diagnostic yield, with most Causes of pouch dysfunction identifiable during this procedure. The risk of developing dysplasia following RPC is low. Surveillance pouchoscopy is only recommended in those with FAP, those with a previous history of dysplasia or carcinoma, primary sclerosing cholan(litis, those with a retained rectal cuff, and those with Type C histological changes. Flexible pouchoscopy is a useful first-line investigation in patients with pouch dysfunction. It can be performed without sedation and has a high diagnostic yield; it is also important as part of surveillance in FAP and selected UC patients.

AB - Restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis is the surgical procedure of choice for patients with ulcerative colitis (UC). It is also performed in selected patients with familial adenomatous polyposis (FAP). A significant proportion of patients will develop pouch dysfunction. Flexible pouchoscopy is the most important initial investigation in patients with dysfunction. It is also important in UC and FAP surveillance. The aim is to provide gastroenterologists with a clear Understanding of the technique, indications, and diagnostic pitfalls when investigating RPC patients with flexible pouchoscopy. Flexible pouchoscopy for the investigation of RPC patients with pouch dysfunction has a high diagnostic yield, with most Causes of pouch dysfunction identifiable during this procedure. The risk of developing dysplasia following RPC is low. Surveillance pouchoscopy is only recommended in those with FAP, those with a previous history of dysplasia or carcinoma, primary sclerosing cholan(litis, those with a retained rectal cuff, and those with Type C histological changes. Flexible pouchoscopy is a useful first-line investigation in patients with pouch dysfunction. It can be performed without sedation and has a high diagnostic yield; it is also important as part of surveillance in FAP and selected UC patients.

U2 - 10.1002/ibd.20874

DO - 10.1002/ibd.20874

M3 - Literature review

VL - 15

SP - 1256

EP - 1263

JO - Inflammatory Bowel Diseases

JF - Inflammatory Bowel Diseases

IS - 8

ER -