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Mastery of IBD Surgery pp 387–393Cite as

Pouch Excision Versus Diversion for the Failed Pouch

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Abstract

Ileal pouch-anal anastomosis (IPAA), the gold standard restorative procedure after proctocolectomy in patients with ulcerative colitis and familial adenomatous polyposis [1], is durable, associated with a good quality of life (QOL) and excellent outcomes [2–4]. However, pouch failure occurs in a proportion of patients owing to anastomotic leak or stricture, fistula, pelvic sepsis, recurrent pouchitis, and pouch dysfunction [5–9]. When pouch failure occurs, options include a permanent ostomy, pouch repair, revision or redo pouch, or conversion to a continent ileostomy reservoir if this expertise exists at the particular center. When restoration of intestinal continuity or continence is not pursued, pouch excision is usually undertaken. However, performing a permanent ileostomy above a pouch left in-situ is an alternative to pouch excision.

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Authors and Affiliations

  1. Columbia University Medical Center and Mailman School of Public Health, New York, NY, USA

    P. Ravi Kiran

  2. Division of Colorectal Surgery, Center for Innovation and Outcomes Research, New York Presbyterian Hospital-Columbia, New York, NY, USA

    P. Ravi Kiran

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  1. P. Ravi Kiran
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Correspondence to P. Ravi Kiran .

Editor information

Editors and Affiliations

  1. Colon and Rectal Surgery, University of Chicago, Chicago, IL, USA

    Neil Hyman

  2. Section of Colon and Rectal Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA

    Phillip Fleshner

  3. Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Scott Strong

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Kiran, P.R. (2019). Pouch Excision Versus Diversion for the Failed Pouch. In: Hyman, N., Fleshner, P., Strong, S. (eds) Mastery of IBD Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-16755-4_43

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  • DOI: https://doi.org/10.1007/978-3-030-16755-4_43

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-16754-7

  • Online ISBN: 978-3-030-16755-4

  • eBook Packages: MedicineMedicine (R0)

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