Mesenteric Lengthening in Pouch Surgery: Review of Surgical Techniques

• Autor(a) principal: Saad,Melissa Kyriakos
• Data de Publicação: 2021
• Outros Autores: Fiani,Elias, Saikaly,Elias
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Journal of Coloproctology (Rio de Janeiro. Online)
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2237-93632021000400438
• topic: pouch surgery; mesenteric lengthening

Abstract Described for the first time in themedical literature in 1978 by Parks and Nicholls, total proctocolectomy with ileal-pouch anal anastomosis (IPAA) is nowadays the procedure of choice for patients with ulcerative colitis inwhom themedical therapy has, a selected group of patients with Crohń s disease, and for patients with familial adenomatous polyposis. Despite the advances in medical treatment regarding inflammatory bowel disease, up to 30% of patients still require surgery, and restorative proctocolectomy and IPAA are the mainstay of the surgical treatment. It is considered a demanding and technically-challenging procedure, with the main challenge being the performance of a tension-free IPAA; the main reason for failure of the tension-free anastomosis is a shortened mesentery. With particular attention to detail, sufficient length can be achieved to enable a safe anastomosis in most patients. Herein, we describe the available techniques to lengthen the mesentery of the ileal pouch to perform an easyto- reach tension-free anastomosis.