Sacs or reservoirs created to function in place of the COLON and/or RECTUM in patients who have undergone restorative proctocolectomy (PROCTOCOLECTOMY, RESTORATIVE).
The segment of LARGE INTESTINE between the CECUM and the RECTUM. It includes the ASCENDING COLON; the TRANSVERSE COLON; the DESCENDING COLON; and the SIGMOID COLON.
Pathological processes in the COLON region of the large intestine (INTESTINE, LARGE).
The part of the face that is below the eye and to the side of the nose and mouth.
Tumors or cancer of the COLON.
A surgical procedure involving the excision of the COLON and RECTUM and the formation of an ILEOANAL RESERVOIR (pouch). In patients with intestinal diseases, such as ulcerative colitis, this procedure avoids the need for an OSTOMY by allowing for transanal defecation.
A sac or recess formed by a fold of the peritoneum.
Acute INFLAMMATION in the INTESTINAL MUCOSA of the continent ileal reservoir (or pouch) in patients who have undergone ILEOSTOMY and restorative proctocolectomy (PROCTOCOLECTOMY, RESTORATIVE).
Lining of the INTESTINES, consisting of an inner EPITHELIUM, a middle LAMINA PROPRIA, and an outer MUSCULARIS MUCOSAE. In the SMALL INTESTINE, the mucosa is characterized by a series of folds and abundance of absorptive cells (ENTEROCYTES) with MICROVILLI.
Discrete tissue masses that protrude into the lumen of the COLON. These POLYPS are connected to the wall of the colon either by a stalk, pedunculus, or by a broad base.
Inflammation of the COLON that is predominantly confined to the MUCOSA. Its major symptoms include DIARRHEA, rectal BLEEDING, the passage of MUCUS, and ABDOMINAL PAIN.
Inflammation of the COLON section of the large intestine (INTESTINE, LARGE), usually with symptoms such as DIARRHEA (often with blood and mucus), ABDOMINAL PAIN, and FEVER.
A genus of the family Muridae having three species. The present domesticated strains were developed from individuals brought from Syria. They are widely used in biomedical research.
The motor activity of the GASTROINTESTINAL TRACT.
A family of herbivorous leaping MAMMALS of Australia, New Guinea, and adjacent islands. Members include kangaroos, wallabies, quokkas, and wallaroos.
Passage of food (sometimes in the form of a test meal) through the gastrointestinal tract as measured in minutes or hours. The rate of passage through the intestine is an indicator of small bowel function.
Functional obstruction of the COLON leading to MEGACOLON in the absence of obvious COLONIC DISEASES or mechanical obstruction. When this condition is acquired, acute, and coexisting with another medical condition (trauma, surgery, serious injuries or illness, or medication), it is called Ogilvie's syndrome.
Surgical creation of an external opening into the ILEUM for fecal diversion or drainage. This replacement for the RECTUM is usually created in patients with severe INFLAMMATORY BOWEL DISEASES. Loop (continent) or tube (incontinent) procedures are most often employed.
A pathological condition characterized by the presence of a number of COLONIC DIVERTICULA in the COLON. Its pathogenesis is multifactorial, including colon aging, motor dysfunction, increases in intraluminal pressure, and lack of dietary fibers.
The normal process of elimination of fecal material from the RECTUM.
The terminal segment of the LARGE INTESTINE, beginning from the ampulla of the RECTUM and ending at the anus.
Surgical union or shunt between ducts, tubes or vessels. It may be end-to-end, end-to-side, side-to-end, or side-to-side.
A specialty concerned with the use of x-ray and other forms of radiant energy in the diagnosis and treatment of disease.
Tumors or cancer of the RECTUM.
Surgery performed on the digestive system or its parts.
Failure of voluntary control of the anal sphincters, with involuntary passage of feces and flatus.
The distal segment of the LARGE INTESTINE, between the SIGMOID COLON and the ANAL CANAL.
Procedures used to reconstruct, restore, or improve defective, damaged, or missing structures.
Inflammation of any segment of the ILEUM and the ILEOCECAL VALVE.
A polyposis syndrome due to an autosomal dominant mutation of the APC genes (GENES, APC) on CHROMOSOME 5. The syndrome is characterized by the development of hundreds of ADENOMATOUS POLYPS in the COLON and RECTUM of affected individuals by early adulthood.
The pattern of GENE EXPRESSION at the level of genetic transcription in a specific organism or under specific circumstances in specific cells.
The determination of the pattern of genes expressed at the level of GENETIC TRANSCRIPTION, under specific circumstances or in a specific cell.
Hybridization of a nucleic acid sample to a very large set of OLIGONUCLEOTIDE PROBES, which have been attached individually in columns and rows to a solid support, to determine a BASE SEQUENCE, or to detect variations in a gene sequence, GENE EXPRESSION, or for GENE MAPPING.
A partial or complete return to the normal or proper physiologic activity of an organ or part following disease or trauma.
Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.
A form of long QT syndrome that is associated with congenital deafness. It is characterized by abnormal cardioelectrophysiology involving the VOLTAGE-GATED POTASSIUM CHANNEL. It results from mutation of KCNQ1 gene (Subtype 1 or JLN1) or the KCNE1 gene (Subtype 2 or JLN2).
An organized procedure carried out by a select committee of professionals in evaluating the performance of other professionals in meeting the standards of their specialty. Review by peers is used by editors in the evaluation of articles and other papers submitted for publication. Peer review is used also in the evaluation of grant applications. It is applied also in evaluating the quality of health care provided to patients.
The application of current standards of morality to past actions, institutions, or persons.
Association with or participation in an act that is, or is perceived to be, criminal or immoral. One is complicitous when one promotes or unduly benefits from practices or institutions that are morally or legally suspect.
The concurrent or retrospective review by practicing physicians or other health professionals of the quality and efficiency of patient care practices or services ordered or performed by other physicians or other health professionals (From The Facts On File Dictionary of Health Care Management, 1988).
The evaluation by experts of the quality and pertinence of research or research proposals of other experts in the same field. Peer review is used by editors in deciding which submissions warrant publication, by granting agencies to determine which proposals should be funded, and by academic institutions in tenure decisions.
A vessel that directly interconnects an artery and a vein, and that acts as a shunt to bypass the capillary bed. Not to be confused with surgical anastomosis, nor with arteriovenous fistula.
The surgical construction of an opening between the colon and the surface of the body.
Breakdown of the connection and subsequent leakage of effluent (fluids, secretions, air) from a SURGICAL ANASTOMOSIS of the digestive, respiratory, genitourinary, and cardiovascular systems. Most common leakages are from the breakdown of suture lines in gastrointestinal or bowel anastomosis.
A technique of closing incisions and wounds, or of joining and connecting tissues, in which staples are used as sutures.
A bibliographic database that includes MEDLINE as its primary subset. It is produced by the National Center for Biotechnology Information (NCBI), part of the NATIONAL LIBRARY OF MEDICINE. PubMed, which is searchable through NLM's Web site, also includes access to additional citations to selected life sciences journals not in MEDLINE, and links to other resources such as the full-text of articles at participating publishers' Web sites, NCBI's molecular biology databases, and PubMed Central.
A publication issued at stated, more or less regular, intervals.
"The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing.
The premier bibliographic database of the NATIONAL LIBRARY OF MEDICINE. MEDLINE® (MEDLARS Online) is the primary subset of PUBMED and can be searched on NLM's Web site in PubMed or the NLM Gateway. MEDLINE references are indexed with MEDICAL SUBJECT HEADINGS (MeSH).
Publications in any medium issued in successive parts bearing numerical or chronological designations and intended to be continued indefinitely. (ALA Glossary of Library and Information Science, 1983, p203)
All of the divisions of the natural sciences dealing with the various aspects of the phenomena of life and vital processes. The concept includes anatomy and physiology, biochemistry and biophysics, and the biology of animals, plants, and microorganisms. It should be differentiated from BIOLOGY, one of its subdivisions, concerned specifically with the origin and life processes of living organisms.

Similar outcome after colonic pouch and side-to-end anastomosis in low anterior resection for rectal cancer: a prospective randomized trial. (1/75)

OBJECTIVES: To compare a colonic J-pouch or a side-to-end anastomosis after low-anterior resection for rectal cancer with regard to functional and surgical outcome. SUMMARY BACKGROUND DATA: A complication after restorative rectal surgery with a straight anastomosis is low-anterior resection syndrome with a postoperatively deteriorated anorectal function. The colonic J-reservoir is sometimes used with the purpose of reducing these symptoms. An alternative method is to use a simple side-to-end anastomosis. METHODS: One-hundred patients with rectal cancer undergoing total mesorectal excision and colo-anal anastomosis were randomized to receive either a colonic pouch or a side-to-end anastomosis using the descending colon. Surgical results and complications were recorded. Patients were followed with a functional evaluation at 6 and 12 months postoperatively. RESULTS: Fifty patients were randomized to each group. Patient characteristics in both groups were very similar regarding age, gender, tumor level, and Dukes' stages. A large proportion of the patients received short-term preoperative radiotherapy (78%). There was no significant difference in surgical outcome between the 2 techniques with respect to anastomotic height (4 cm), perioperative blood loss (500 ml), hospital stay (11 days), postoperative complications, reoperations or pelvic sepsis rates. Comparing functional results in the 2 study groups, only the ability to evacuate the bowel in <15 minutes at 6 months reached a significant difference in favor of the pouch procedure. CONCLUSIONS: The data from this study show that either a colonic J-pouch or a side-to-end anastomosis performed on the descending colon in low-anterior resection with total mesorectal excision are methods that can be used with similar expected functional and surgical results.  (+info)

Long-term functional results after ileal pouch anal restorative proctocolectomy for ulcerative colitis: a prospective observational study. (2/75)

OBJECTIVE: To document functional results in patients treated with an ileal pouch anal anastomosis (IPAA). SUMMARY BACKGROUND DATA: The restorative proctocolectomy with IPAA has become the procedure of choice for patients with ulcerative colitis, yet the long-term functional results are not well known. METHODS: We performed this prospective observational study in 391 consecutive patients (56% male; mean age, 33.7 +/- 10.8 years; range, 12-66 years) who underwent an IPAA between 1987 and 2002 (mean follow-up, 33.6 months; range, 0 to 180 months). RESULTS: The majority of patients underwent the procedure under elective circumstances with a hand-sewn ileal pouch anal anastomosis and a protective ileostomy. In 25 patients (6.4%), the procedure was performed under urgent conditions; in 137 patients (35%), the temporary ileostomy was omitted; in 117 patients (29.9%), the ileal pouch anal anastomosis was stapled. There was 1 hospital mortality (0.25%) and 1 30-day mortality. Mean length of stay was 9.2 +/- 5.6 days (3-68 days; median, 8 days) and was increased by the occurrence of septic complications (8.9 versus 13.6 days; P < 0.02) and by the omission of a temporary ileostomy (8.3 versus 10.4 days; P = 0.005). Complications included pelvic abscess (1.3%), anastomotic dehiscence (6.4%), bowel obstruction (11.7%), and anastomotic stenosis in need of mechanical dilatation (10.7%). Patients were asked to record their functional results on a questionnaire for 1 week at 3, 6, 9, 12, 18, and 24 months after the IPAA and yearly thereafter. Our data to 10 years show that median number of bowel movements (bms) was 6 bm/24 hours at all time intervals. The average number of bms increased by 0.3 bm/decade of life (P < 0.001). Throughout the entire follow-up, more than 75% of patients had at least 1 bm most nights, although fewer than 40% found it necessary to alter the time of their meals to avoid bms at inappropriate times. Depending on the time interval, between 57% and 78% of patients were always able to postpone a bm until convenient, and this ability was similar in patients with a stapled or hand-sewn ileoanal anastomosis; only up to 18% were able to always distinguish between flatus and stools, and this ability was similar in patients with a stapled or hand-sewn ileoanal anastomosis. Complete daytime and nighttime continence was achieved by 53-76% of patients depending on the time interval. The percentage of fully continent patients was higher following the stapled rather than the hand-sewn technique (P < 0.001), and this difference persisted over time. When patients experienced incontinence, its occurrence ameliorated over time (P < 0.001), and the occurrence of perianal rash and itching as well as the use of protective pads decreased over time (P < 0.008). At 5 years, patients judged quality of life as much better or better in 81.4% and overall satisfaction and overall adjustment as excellent or good in 96.3% and 97.5%, respectively. CONCLUSIONS: We conclude that the IPAA confers a good quality of life. The majority of patients are fully continent, have 6 bms/d on average, and can defer a bm until convenient. When present, incontinence improves over time.  (+info)

Training in trauma surgery: quantitative and qualitative aspects of a new paradigm for fellowship. (3/75)

OBJECTIVE: To describe outcomes from a clinical trauma surgical education program that places the board-eligible/board-certified fellow in the role of the attending surgeon (fellow-in-exception [FIE]) during the latter half of a 2-year trauma/surgical critical care fellowship. SUMMARY BACKGROUND DATA: National discussions have begun to explore the question of optimal methods for postresidency training in surgery. Few objective studies are available to evaluate current training models. METHODS: We analyzed provider-specific data from both our trauma registry and performance improvement (PI) databases. In addition, we performed TRISS analysis when all data were available. Registry and PI data were analyzed as 2 groups (faculty trauma surgeons and FIEs) to determine experience, safety, and trends in errors. We also surveyed graduate fellows using a questionnaire that evaluated perceptions of training and experience on a 6-point Likert scale. RESULTS: During a 4-year period 7,769 trauma patients were evaluated, of which 46.3% met criteria to be submitted to the PA Trauma Outcome Study (PTOS, ie, more severe injury). The faculty group saw 5,885 patients (2,720 PTOS); the FIE group saw 1,884 patients (879 PTOS). The groups were similar in respect to mechanism of injury (74% blunt; 26% penetrating both groups) and injury severity (mean ISS faculty 10.0; FIEs 9.5). When indexed to patient contacts, FIEs did more operations than the faculty group (28.4% versus 25.6%; P < 0.05). Death rates were similar between groups (faculty 10.5%; FIEs 10.0%). Analysis of deaths using PI and TRISS data failed to demonstrate differences between the groups. Analysis of provider-specific errors demonstrated a slightly higher rate for FIEs when compared with faculty when indexed to PTOS cases (4.1% versus 2.1%; P < 0.01). For both groups, errors in management were more common than errors in technique. Twenty-one (91%) of twenty-three surveys were returned. Fellows' feelings of preparedness to manage complex trauma patients improved during the fellowship (mean 3.2 prior to fellowship versus 4.5 after first year versus 5.8 after FIE year; P < 0.05 by ANOVA). Eighty percent rated the FIE educational experience "great -5" or "exceptional- 6." Eighty-five percent consider the current structure of the fellowship (with FIE year) as ideal. Ninety percent would repeat the fellowship. CONCLUSION: The educational experience and training improvement offered by the inclusion of a FIE period during a trauma fellowship is exceptional. Patient outcomes are unchanged. The potential for an increased error rate is present during this period of clinical autonomy and must be addressed when designing the methods of supervision of care to assure concurrent senior staff review.  (+info)

Quantification of risk for pouch failure after ileal pouch anal anastomosis surgery. (4/75)

OBJECTIVE: To identify risk factors associated with ileal pouch failure and to develop a multifactorial model for quantifying the risk of failure in individual patients. SUMMARY BACKGROUND DATA Ileal pouch anal anastomosis (IPAA) has become the treatment choice for most patients with ulcerative colitis and familial adenomatous polyposis who require surgery. At present, there are no published studies that investigate collectively the interrelation of factors related to ileal pouch failure, nor are there any predictive indices for risk stratification of patients undergoing IPAA surgery. METHODS: Data from 23 preoperative, 7 intraoperative, and 10 postoperative risk factors were recorded from 1,965 patients undergoing restorative proctocolectomy in a single center between 1983 and 2001. Primary end point was ileal pouch failure during the follow-up period of up to 19 years. The "CCF ileal pouch failure" model was developed using a parametric survival analysis and a 70%:30% split-sample validation technique for model training and testing. RESULTS: The median patient follow-up was 4.1 year (range, 0-19 years). Five-year ileal pouch survival was 95.6% (95% CI, 94.4-96.7). The following risk factors were found to be independent predictors of pouch survival and were used in the final multivariate model: patient diagnosis, prior anal pathology, abnormal anal manometry, patient comorbidity, pouch-perineal or pouch-vaginal fistulae, pelvic sepsis, anastomotic stricture and separation. The model accurately predicted the risk of ileal pouch failure with adequate calibration statistics (Hosmer Lemeshow chi2 = 3.001; P = 0.557) and an area under the receiver operating characteristics curve of 82.0%. CONCLUSIONS: The CCF ileal pouch failure model is a simple and accurate way of predicting the risk of ileal pouch failure in clinical practice on a longitudinal basis. It may play an important role in providing risk estimates for patients wishing to make informed choices on the type of treatment offered to them.  (+info)

Short- and long-term outcomes of ileal pouch-anal anastomosis for ulcerative colitis. (5/75)

Ileal pouch-anal anastomosis was an important advancement in the treatment of ulcerative colitis. The aim of this study was to determine whether early complications of ileal pouch-anal anastomosis in patients with ulcerative colitis are associated with poor late functional results. PATIENTS AND METHODS: Eighty patients were operated on from 1986 to 2000, 62 patients with ileostomy and 18 without. The early and late complications were recorded. Specific emphasis has been placed on the incidence of pouchitis with prolonged follow-up. RESULTS: The ileostomy was closed an average of 9.2 months after the first operation. Fourteen patients were excluded from the long-term evaluation; 6 patients were lost to regular follow-up, 4 died, and 4 patients still have the ileostomy. Of the 4 patients that died, 1 died from surgical complications. Early complications after operation (41) occurred in 34 patients (42.5%). Late complications (29) occurred in 25 patients as follows: 16 had pouchitis, 3 associated with stenosis and 1 with sexual dysfunction; 5 had stenosis; and there was 1 case each of incisional hernia, ileoanal fistula, hepatic cancer, and endometriosis. Pouchitis occurred in 6 patients (9.8%) 1 year after ileal pouch-anal anastomosis, 9 (14.8%) after 3 years, 13 (21.3%) after 5 years, and 16 (26.2%) after more than 6 years. The mean daily stool frequency was 12 before and 5.8 after operation. One pouch was removed because of fistulas that appeared 2 years later. CONCLUSIONS: Ileal pouch-anal anastomosis is associated with a considerable number of early complications. There was no correlation between pouchitis and severe disease, operation with or without ileostomy, or early postoperative complications. The incidence of pouchitis was directly proportional to duration of time of follow-up.  (+info)

Could laparoscopic colon and rectal surgery become the standard of care? A review and experience with 750 procedures. (6/75)

INTRODUCTION: The benefits of the laparoscopic approach to colon and rectal surgery do not seem as great as for other laparoscopic procedures. To study this further we decided to review the current literature and the 10-year experience of a surgical group from university teaching hospitals in Montreal, Quebec and Toronto in performing laparoscopic colon and rectal surgery. METHODS: The prospectively designed case series comprised all patients having laparoscopic colon and rectal surgery. The procedures were carried out by a group of 4 surgeons between April 1991 and November 2001. We noted intraoperative complications, any conversions to open surgery, operating time, postoperative complications and postoperative length of hospital stay. RESULTS: The group attempted 750 laparoscopic colon and rectal procedures of which 669 were completed laparoscopically. Malignant disease was the indication for surgery in 49.6% of cases. Right hemicolectomy and sigmoid colectomy accounted for 54.5% of procedures performed. Intraoperative complications occurred in 8.3%, with 29.0% of these resulting in conversion to open surgery. The overall rate of conversion to open surgery was 10.8%, most commonly for oncologic concerns. Median operating time was 175 minutes for all procedures. Postoperative complications occurred in 27.5% of procedures completed laparoscopically but were mostly minor wound complications. Pulmonary complications occurred in only 1.0%. The anastomotic leak rate was 2.5%. The early reoperation rate was 2.4%. Postoperative mortality was 2.2%. No port site metastases have yet been detected. The median postoperative length of stay was 5 days. CONCLUSIONS: The clinical outcomes of laparoscopic colon and rectal surgery in this 10-year experience are consistent with numerous cohort studies and randomized clinical trials. Laparoscopic colon and rectal surgery in the hands of well-trained surgeons can be performed safely with short hospital stay, low analgesic requirements and acceptable complication rates compared with historical controls and other reports in the literature. Evidence from published randomized clinical trials is emerging that under these conditions laparoscopic resection represents the better treatment option for most benign conditions, but concerns regarding its appropriateness for malignant disease are still to be resolved.  (+info)

Continent diversions: the new gold standards of ileoanal reservoir and neobladder. (7/75)

In recent decades, surgical treatment of familial adenomatous polyposis, chronic ulcerative colitis, and muscle-invasive bladder cancer has undergone a revolution. Specifically, ileoanal reservoir and neobladder have become the new "gold standard" of definitive surgical therapy for these disorders. This article discusses issues in surgical construction, indications, contraindications, perioperative care concepts, and nursing and health professional implications related to these two procedures. These interventions include screening candidates for ileoanal reservoir or neobladder to rule out Crohn's disease or metastatic cancer and educating candidates for continent diversions about the proposed procedure(s) and associated events, potential complications, postoperative exercise, sexual health and function issues, and the benefits of support group participation so they can gain a realistic understanding of ultimate functional outcomes. Questions for future research are addressed.  (+info)

The effect of ageing on function and quality of life in ileal pouch patients: a single cohort experience of 409 patients with chronic ulcerative colitis. (8/75)

OBJECTIVE: To evaluate in what manner ageing affects functional outcome and quality of life (QoL) in patients with chronic ulcerative colitis (CUC) after ileal pouch-anal anastomosis (IPAA). SUMMARY BACKGROUND DATA: Short-term function and QoL after IPAA is good. However, patients are usually young, and little is known about the influence of time and ageing on long-term outcomes after IPAA. METHODS: Using a standardized questionnaire, functional outcome, QoL, and complications were assessed prospectively in a cohort of 409 patients followed annually for 15 years after IPAA. RESULTS: Follow-up was complete in the single cohort of 409 patients and functional and QoL outcomes summarized at 5, 10, and 15 years. Daytime stool frequency changed little (mean 6), while nighttime frequency increased from 1 stool to 2 stools. Incontinence for gas and stool increased from 1% to 10% during the day and from 2% to 24% at night over 15 years. The cumulative probability of pouchitis increased from 28% at 5 years to 38% at 10 years and to 47% at 15 years. Bowel obstruction and stricture were other principal long-term complications. At 15 years, 91% of patients had kept the same job. Work was not affected by the surgery in 83%, while social activities, sports, traveling, and sexual life all improved after surgery and did not deteriorate over time. CONCLUSIONS: These long-term results in a single cohort of 409 IPAA patients are unique and are likely a more accurate reflection of long-term outcome than has been previously reported. These data support the conclusion that IPAA is a durable operation for patients requiring proctocolectomy for CUC; functional and QoL outcomes are good, predictable, and stable for 15 years after operation.  (+info)

INTRODUCTION:. Ileal pouch anal anastomosis (IPAA) is the standard procedure for reconstruction after colectomy for ulcerative colitis (UC). However, ileorectal anastomosis (IRA) as an alternative has, recently experienced a revival. This study from a single center compares the clinical outcomes of these procedures.. METHODS:. From 1992 to 2006, 253 patients consecutively underwent either IRA (n=105) or IPAA (n=148). Selection to either procedure was determined on the basis of rectal inflammation, presence of dysplasia/cancer or patient preferences. Patient-records were retrospectively evaluated. Mean follow-up time was 5.4 and 6.3 years respectively.. RESULTS:. Major postoperative complications occurred in 12.4% of patients after IRA and in 12.8% after IPAA (ns). Complications of any kind after IRA or IPAA, even including subsequent stoma-closure, occurred in 23.8% and 39.9% respectively (p,0.01). Estimated cumulative failure rates after 5 and 10 years were 10.1% and 24.1% for IRA and 6.1% and ...
ASA 2018 Abstracts: Better Function With A Colonic J-pouch Or A Side-to-end Anastomosis? A Randomized Controlled Trial To Compare The Complications, Functional Outcome And Quality Of Life In Patients With Low Rectal Cancer After A J-pouch Or A Side-to- End Anastomosis
Pouch salvage surgeries can avoid RPC/IPAA surgery failure. Pouch salvage operations are divided to two groups: Trans perineal and trans abdominal approaches (8). In the trans abdominal approach, the surgeon mobilizes the pouch, and depending on the pouch condition and small bowel mesentery length, the pouch will be removed or left in place. Then mucosectomy of rectal mucosa down to dentate line will be performed and at the end, hand sewn pouch anal anastomosis will complete the operation. Diverting ileostomy will be performed in most cases. Trans perineal approaches include fistulotomy for very low fistulas, advancement flap or muscle transposition for high fistulas and pouch-vaginal fistulas, or rectal mucosectomy plus pouch mobilization with pouch anal anastomosis for remained rectal mucosa or stricture at pouch anal anastomosis site. Four major complications resulting in pouch surgery failure were observed with sepsis being the most common factor. Sepsis could occur early, immediately after ...
Colonic J-pouch is a type of neorectum, performed during surgery for rectal cancer. This may improve the quality of life of patients over a straight end-to-end anastomosis by forming a reservoir for faeces with patients experiencing less urgency ...
The ileoanal pouch anastomosis is the procedure of choice for ulcerative colitis and familial adenomatosis polyposis, but can be complicated by anastomotic leak. We discuss the presentation, management, and outcome of 141 leaks after the ileoanal pouch anastomosis procedure in 1424 patients, and propose a management algorithm. Using a combination of nonoperative and operative means and tailoring the management to the presentation of the leak, we were able to achieve an 84% success rate in treating pouches complicated by leaks ...
The UC pouch, well before histologic inflammation, already displays a systems-level gain of colon-associated genes and loss of ileum-associated genes. Patients with UC exhibit a unique transcriptomic response to ileal pouch creation that can be observed well before disease and may in part explain th …
Casie, while I still recommend taking your time with this, it was a REALLY great feeling to go home from the hospital with all of my drugs discontinued - no more IV cyclosporine, Imuran, Apriso, Colozal, Canasa, Cortifoam and a fast taper off Prednisone.
It is what it is! Remicade wasnt really a question for me, the doctor told me I needed it so I agreed to it blindly. I didnt know enough of the side effects at the time and thought it would definitely work and felt it was my only hope. If I had had the disease for longer and researched all possibilities I may have refused it as well. This is a very tricky situation. You never know what will work or how much the disease will spread/worsen. Im under the impression that our fate is decided...
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Tube Construction Carry-All Pouch by Rob Hans. Our pouches are great. Theyre availabe in sizes from 6 x 5 up to 12.5 x 8.5. Each pouch is printed on both sides (same image).
Bleeding with j-pouch Drinking water is healthy. I try to drink as much as I can. Liquid isnt the worst, at least its easy to pass and its quick. It takes 2 seconds. The worst is when you have to wipe a lot. Id take.... ...
AccessGUDID - Instrument pouch (05051223004264)- The Instrument Pouch is used for securing instruments in a convenient housing close to the surgical site, minimising hand to hand transfer.
Both the developed and the emerging economies are showing a great demand for packed food products. This has provided a momentum to the retort pouch market growth.
countries:[{id:4,name:Afghanistan,region_id:1},{id:17,name:Åland Islands,region_id:1},{id:7,name:Albania,region_id:1},{id:64,name:Algeria,region_id:1},{id:13,name:American Samoa,region_id:3},{id:2,name:Andorra,region_id:1},{id:10,name:Angola,region_id:1},{id:6,name:Anguilla,region_id:1},{id:11,name:Antarctica,region_id:1},{id:5,name:Antigua and ...
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TY - JOUR. T1 - Risk factors for diseases of ileal pouch-anal anastomosis after restorative proctocolectomy for ulcerative colitis. AU - Shen, Bo. AU - Fazio, Victor W.. AU - Remzi, Feza H.. AU - Brzezinski, Aaron. AU - Bennett, Ana E.. AU - Lopez, Rocio. AU - Hammel, Jeffrey P.. AU - Achkar, Jean Paul. AU - Bevins, Charles L.. AU - Lavery, Ian C.. AU - Strong, Scott A.. AU - Delaney, Conor P.. AU - Liu, Wendy. AU - Bambrick, Marlene L.. AU - Sherman, Kerry K.. AU - Lashner, Bret A.. N1 - Copyright: Copyright 2008 Elsevier B.V., All rights reserved.. PY - 2006/1. Y1 - 2006/1. N2 - Background & Aims: Although pouchitis is considered the most common adverse sequela of ileal pouch-anal anastomosis (IPAA), inflammatory and noninflammatory conditions other than pouchitis are increasingly being recognized. The risk factors for these non-pouchitis conditions, including Crohns disease (CD) of the pouch, cuffitis, and irritable pouch syndrome (IPS), have not been studied. The aim of this study was to ...
Introduction. Restorative surgery for ulcerative colitis with ileal pouch anal anastomosis (IPAA) is frequently accompanied by complications. Volvulus of the ileal pouch is one of the most rarely reported late complications and to our knowledge no report exists on reoperative surgery for this condition. Case Report. A 58-year-old woman who previously had undergone restorative proctocolectomy due to ulcerative colitis with an IPAA presented with volvulus of the pouch. She was operated with a single row pouchopexy to the presacral fascia. Two months later she returned with a recurrent volvulus. At reoperation, the pouch was found to have become completely detached from the fascia. A new pexy was made by firmly anchoring the pouch with two rows of sutures to the presacral fascia as well as with sutures to the lateral pelvic walls. At follow-up after five months she was free of symptoms. Conclusion. This first report ever on reoperative surgery for volvulus of a pelvic pouch indicates that a single ...
|i|Introduction|/i|. Restorative surgery for ulcerative colitis with ileal pouch anal anastomosis (IPAA) is frequently accompanied by complications. Volvulus of the ileal pouch is one of the most rarely reported late complications and to our knowledge no report exists on reoperative surgery for this condition. |i|Case Report.|/i| A 58-year-old woman who previously had undergone restorative proctocolectomy due to ulcerative colitis with an IPAA presented with volvulus of the pouch. She was operated with a single row pouchopexy to the presacral fascia. Two months later she returned with a recurrent volvulus. At reoperation, the pouch was found to have become completely detached from the fascia. A new pexy was made by firmly anchoring the pouch with two rows of sutures to the presacral fascia as well as with sutures to the lateral pelvic walls. At follow-up after five months she was free of symptoms. |i|Conclusion|/i|. This first report ever on reoperative surgery for volvulus of a pelvic pouch indicates
Procedure that combines complete removal of the colon and creation of a new rectum using the ileum. This procedure may also be referred to as ileal reservoir reconstruction, ileal pouch-anal anastomosis, restorative proctocolectomy, or W-, S-, or J-pouch reconstruction.
Mays issue of Colorectal Disease reviews the quality of life, health-related quality of life and health status in patients having restorative proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis.. ...
Though uncommon, ileoanal pouch-vaginal fistulas after restorative proctocolectomy present quite a challenge. Multiple salvage procedures, including endoanal, transabdominal, and transvaginal, have been used. Because of high recurrence rates, multiple operations are not uncommon, and ultimate pouch failure rates have been reported as high as 45 per cent. The Permacolâ„¢ Collagen Implant is a surgical implant that has been used successfully in a variety of operations ranging from urological to maxillofacial. Its properties allow fibroblast infiltration and revascularization so that it gradually becomes permanently incorporated into the surrounding tissue, providing strength and inhibiting scarring and contraction. We report the first documented case of Permacolâ„¢ use in repair of ileoanal pouch-vaginal fistula and we feel that it warrants further investigation as an option in the treatment of these fistulas ...
A flexible pouch includes a flexible compartment with a bottom. A rim is formed around the bottom of the compartment and is spaced from and extends outwardly from this compartment bottom. At least three coplanar feet are provided on the rim for stabilizing the pouch when the pouch is resting on the rim. These coplanar feet can be generally flush with the rim when the pouch is in a flat, empty position. However, when the compartment of the pouch is filled, the coplanar feet will be formed as the lowermost portions of the rim. The pouch will rest on these coplanar feet when on a support to be stably held in position. This pouch design will avoid wobbling or tipping over of the pouch and therefore minimize or eliminate product spillage. Also, a method for making this pouch includes the steps of forming the pouch with the compartment, providing a rim around the bottom of the compartment, and spacing the rim from the bottom of the compartment. A portion of this rim is then removed at the outer edge to form
Guaranteed low prices on closed pouches. MSEC offers a variety of closed pouches, closed pouches, colostomyileostomy systems, drainable bags pouches, fistula wound pouches, irrigation pouches products, ostomy pouch accessories, pediateric ostomy systems, skin barriers and urostomy pouches accessories. In addition to our wide selection of closed pouches, you can choose from different types of products to customize your nedds for optimal comfort and practicality.
If you are a society or association member and require assistance with obtaining online access instructions please contact our Journal Customer Services team ...
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The 3M™ Paintable Undercoating Pouch makes for fast, cost-efficient undercoating application. Durable rubberized coating is packaged and delivered in a job-sized pouch, and works with our Accuspray™ system for consistent, accurate coverage. The 3M™ Paintable Undercoating Pouch used with 3M™ Accuspray™ technology may be applied in a range of textures to easily and accurately match OEM finishes.
Aquatica Carry-All Pouch by Maria Bonnier-Perez. Our pouches are great. Theyre availabe in sizes from 6 x 5 up to 12.5 x 8.5. Each pouch is printed on both sides (same image).
Tailorbird impressive contrast animal medium pouch by Wannathis. The Tailorbird medium pouch is a cute and well made medium sized zipper pouch.
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Buy Scc 4 Pouch - packet of 1 gm Pouch at online at 1mg.com. Know the uses, side effects, price, composition, substitutes, How it works, Precautions and Expert Advice for Scc 4 Pouch manufactured by Maneesh Pharmaceuticals Ltd
This version of the Outdoor Trauma Kit contains critical first aid equipment in a convenient smaller pouch, providing more versatility on the go. This small pouch easily fits in your bag, backpack, or tackle box and is always with you in the event of an emergency. From small cuts to massive bleeding situation, be prepared with the Outdoor Trauma Kit ...
Ponsky Endo-Sock Retrieval Pouch is designed with a preloaded, ready to use, urethane pouch that automatically opens by advancing the handle.
Vetoquinol Enisyl-F Lysine Treats Re-Closable Pouch 6.35 OZ VETOQUINOL Enisyl-F Lysine Treats 6.35 oz Re-Closable Pouch (180gm) 1-Pack
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PURPOSE: Disconnection of an ileal pouch-anal anastomosis with repeat ileal pouch-anal anastomosis has been proposed for treatment of ileal pouch-anal anastomosis failure caused by septic or functional complications. We report our experience with repeat ileal pouch-anal anastomosis, and document functional outcome and quality of life.. METHODS: Of 101 patients undergoing laparotomy, ileoanal disconnection, and repeat ileal pouch-anal anastomosis, 80 were referred from other institutions. Indications included: chronic anastomotic leak (n=27), perineal or pouch-vaginal fistula (n=47), anastomotic stricture (n=22), dysfunction/long efferent limb of S-pouch (n=36), and previous ileal pouch-anal anastomosis excision or exclusion (n=6). In 64 cases a septic indication was observed. Pathologic features of Crohns disease were present in 4 patients preoperatively and 15 more after repeat ileal pouch-anal anastomosis. Four patients had clinical features of Crohns disease.. RESULTS: Three patients had ...
PURPOSE: Pathophysiology of pouchitis after ileal pouch-anal anastomosis is controversial because of the potential for development of carcinoma. Cyclooxygenase-2-derived prostaglandins may be involved in the inflammatory process and play a role in the pathogenesis of colon cancer. Vascular endothelial growth factor plays a major role in neoangiogenesis and is overexpressed in a number of gastrointestinal malignancies. The goal of this study was to evaluate the expression of cyclooxygenase-2 and vascular endothelial growth factor and to assess neoangiogenesis and epithelial cell proliferation in patients with ileal pouch-anal anastomosis. METHODS: Endoscopic biopsies were obtained from 15 patients with ileal pouch-anal anastomosis without pouchitis (10 biopsies from the ileal pouch and 10 from ileal nonpouch mucosa) and from 15 subjects with irritable bowel syndrome (10 biopsies from normal-appearing ileum and rectum). Cyclooxygenase-1, cyclooxygenase-2, and vascular endothelial growth factor ...
There is no quality evidence of the benefit of defunctioning ileostomy (DI) in ileal pouch-anal anastomoses (IPAAs) performed for inflammatory bowel disease (IBD), but most surgical teams currently resort to DI. In the case of a staged procedure with subtotal colectomy first, completion proctectomy with IPAA is performed for healthy patients, namely, after nutritional support, inflammation reduction and immunosuppressive agent weaning. Therefore, the aim of this trial is to assess the need for systematic DI after completion proctectomy and IPAA for IBD. This is a multicenter randomized open trial comparing completion proctectomy and IPAA without (experimental) or with (control) DI in patients presenting with ulcerative colitis or indeterminate colitis. Crohns disease patients will not be included. The design is a superiority trial. The main objective is to compare the 6-month global postoperative morbidity, encompassing both surgical and medical complications, between the two groups. The morbidity of
The detrimental effects of catabolism, insuline resistance and muscle wasting on surgical outcome is wellknown. This catabolism is especially pronounced in patients with acute or chronic inflammation (IBD, cancer) and for those undergoing major surgery. Patients with ulcerative colitis operated with an ileal pouch-anal anastomosis (j-pouch) fall well into both these categories.. To prevent this undesirable catabolism, we will investigate the effects of intravenous administration of predominantly anabolic amino acids (with an amino acid content equal to breast milk) on whole body metabolism, with special emphasis on muscle and fat metabolism and intracellular signalling pathways.. Twenty-four patients will be block-randomized by gender in this parallel-group, randomized, assessor-blinded, placebo-controlled trial to receive either Vaminolac® (Fresenius Kabi) or saline. Metabolism before and after the intervention will be assessed by palmitate- and amino acid kinetics of radioactively labelled ...
Objective: To evaluate the pregnancies, deliveries and functional results of patients who have undergone and ileal pouch-anal anastomosis. Design: A retrospective survey by questionnaire. Setting: The
MOKHELE, N N; THOMSON, S R and WATERMEYER, G A. Predictors of emergency colectomy in patients admitted with acute severe ulcerative colitis. S. Afr. j. surg. [online]. 2017, vol.55, n.3, pp.20-26. ISSN 2078-5151.. BACKGROUND: Acute Severe Ulcerative Colitis (ASUC) is a life-threatening condition which requires urgent and aggressive medical therapy to reduce mortality, morbidity and avoid surgery. To facilitate this process, it is essential to identify patients at high risk of poor outcomes and emergency colectomy. Numerous such risk factors have been described in Western literature, however there is no local data addressing this issue. As such it is unclear if these predictors are applicable in our setting. The aim of this study is thus to identify risk factors for emergency colectomy in patients admitted to Groote Schuur Hospital with ASUC. METHODS: A retrospective cohort study of 98 patients admitted with ASUC between January 2003 and January 2013 was performed. Clinical, demographic, ...
For more than 20 years, BroadcastMed has been innovating digital strategies for healthcare organizations. The company was first in the world to broadcast live surgeries on the internet using its ORLive solution which provides an intimate look inside the operating room.. ...
Adenocarcinoma in an ileoanal pouch formed for ulcerative colitis in a patient with primary sclerosing cholangitis and a liver transplant: report of a case and
TY - JOUR. T1 - Safety, feasibility, and short-term outcomes of laparoscopic ileal-pouch-anal anastomosis. T2 - A single institutional case-matched experience. AU - Larson, David W.. AU - Cima, Robert R.. AU - Dozois, Eric J.. AU - Davies, Michael. AU - Piotrowicz, Karen. AU - Barnes, Sunni A.. AU - Wolff, Bruce. AU - Pemberton, John. PY - 2006/5/1. Y1 - 2006/5/1. N2 - OBJECTIVE: To compare safety and short-term outcomes of 100 laparoscopic ileal pouch-anal anastomosis (IPAA) versus 200 conventional open IPAA patients. SUMMARY BACKGROUND DATA: Outcomes of laparoscopic IPAA (LAP-IPAA) have been incompletely characterized. Previous reports are characterized by small numbers of patients and rarely include case-matched or randomized trial methodology. This report describes 100 LAP-IPAA patients case matched to 200 open IPAA patients. METHODS: Between 1998 and 2004, 100 consecutive LAP-IPAA patients (75 laparoscopic assisted, 25 hand assisted) were identified and case matched to 200 open IPAA control ...
The team estimated the cumulative risk of pouchitis using a Kaplan-Meier life table analysis.. The researchers reported joint symptoms during steroid tapering by 22% of the ulcerative colitis patients.. Each of these patients had involvement of the small joints of the hand.. The team found that the main symptoms were pain and stiffness, especially in the morning.. The cumulative risk for developing pouchitis after 10 years was found to be 20% in patients who experienced joint symptoms during steroid tapering.. The researchers found that the cumulative risk for pouchitis was 10% in those without those symptoms.. Dr Nakamuras team concluded, The presence of joint symptoms during steroid tapering is a significant risk factor for the development of pouchitis in patients who have undergone an ileal pouch-anal anastomosis forulcerative colitis. ...
INTRODUCTION: The resolution of pouchitis with metronidazole points to an anaerobic aetiology. Pouchitis is mainly seen in patients with ulcerative colitis pouches (UCP). We have recently found that sulphate reducing bacteria (SRB), a species of strict anaerobe, colonize UCP exclusively. Herein, we aimed to correlate levels of different bacterial species (including SRB) with mucosal inflammation and morphology. METHODS: Following ethical approval, fresh faecal samples and mucosal biopsies were taken from 9 patients with UCP and 5 patients with familial adenomatous polyposis pouches (FAPP). For the purposes of comparison, faecal samples and mucosal biopsies were also taken from the stomas of 7 of the 9 patients with UC (UCS). Colonization by four types of strict anaerobes (SRB, Clostridium perfringens, Bifidobacteria and Bacteroides) as well as by three types of facultative anaerobes (Enterococci, Coliforms and Lactobacilli) was evaluated. Inflammatory scores and mucosal morphology were assessed ...
Medeiros, Bruno Amaral et al. Proctocolectomy and ileal J-pouch anal anastomosis on the surgical treatment of familial adenomatous polyposis and ulcerative colitis: analysis of 49 cases. J. Coloproctol. (Rio J.), Sept 2012, vol.32, no.3, p.260-264. ISSN 2237- ...
Since I got home from the hospital, my stoma has been somewhat retracted. I have a loop ileostomy now, so I have two pieces of my intestine forming my stoma instead of one. The working part retracted quite a bit, but went to the point of near disappearance a couple of days ago. Because the […]. ...
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I had UC for 8 years and got tired of being sick so Iwent and I said, take it out! My GI tried to talk me into a J-pouch but after doing alot of research on it, and talking to my surgeon I decided on the perm ileostomy. My surgeon said that was what he reccomended so that was one reason. A few of the other reasons I chose that were that the jpouch requires two surgeries, and some people, after the take down have to go to the bathroom like 30 timesa day at first! And it can sometimes take a year to get full control over your bowes and even then you can still expect to go 4-7 times a day, with some urgerncy, well that was part of what I was trying to get away from! Also, the jpocuh can develop pouchitis which is apparetnly icky. THere is something called a koch pouch, which I thought about doing, it is where they make a pouch out of your intestines in you stomach and you stick a catheter and drain it a few times a day. I thought that sounded like a good idea, however up research I found out only ...
The Ballistic Response Pouch comes equipped with a SOF® Tourniquet, Tramedic® Trauma Bandage, and petrolatum gauze as well as a minor injury sub-kit. This compact, one-hand accessible, MOLLE-adaptable pouch is ideal for storage in a bag or backpack, car, boat, ATV, or however you like to enjoy the outdoors. Its contents were selected for ease-of-use and effectiveness. Furthermore, the slightly larger pouch allows you the ability to add other components to the kit ...
A strange name, but Oh what fun! Perhaps not the most PC toy if you also keep chipmunks but great otherwise.. These soft and snuggly plush toys feature a pouch to hold T-Nip catnip pouches. They contain top quality catnip and fit neatly into the pouch without the mess of loose catnip. When the catnip expires, just add a new pouch to the toy for another round of fun!. Each toy comes with two pouches, additional pouches are sold separately. The pouches can be frozen to keep the catnip fresh.. Toys are machine washable when the catnip pouch has been removed.. ...
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The Dedicated Pouches section contains tactical gear pouches made specifically for certain items. Here you will find pouches for radios, flashlights, flash bangs, GPS, admin, identification, and more. Available in different colors, there is one to complete your tactical gear load out.
OUTPUT: 135 POUCHES/ MIN POUCHES VOLUME: 50 ML TO 5 L DESIGNED FOR WORKING IN DIFFICULT AND AGGRESSIVE ENVIRONMENTS, THE THD 900 IS PERFECTLY ADAPTED TO FILL AND SEAL THE PREMADE DOYPACK® POUCHES (WITH OR...
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A specimen removal apparatus includes a pouch assembly fabricated from a flexible membrane, a pouch support, a drawstring having a knot and forming a noose disposed circumferentially around a mouth of the pouch assembly, an endoscopic tubular portion, and a drive rod. The pouch assembly includes a plurality of circumferentially disposed guide members advantageously circumferentially spaced apart to define gaps therebetween. The guide members are disposed in a circumferential pathway proximal to the mouth of the pouch assembly. When the drawstring is pulled, the knot is stopped at an end of a guide member and the noose is closed, thereby closing the mouth of the pouch assembly. The pouch assembly is detachable from the apparatus.
Feeling pretty good and getting back to the gym after colitis related colon surgery and figuring out life with a stoma before the final j-pouch procedures.
Feeling pretty good and getting back to the gym after colitis related colon surgery and figuring out life with a stoma before the final j-pouch procedures.
|p|The one-piece system thats gentle on the skin, while remaining secure and easy to use! Flexible and discreet, the Esteem®+ one-piece system is the all-in-one solution that combines the skin barrier and pouch in a single unit, allowing for a simple, secure, and comfortable experience. Available with Durahesive® technology that adheres to skin and protects it from break down. Available with InvisiClose® clipless tail closure. |/p| |p|The Esteem®+ pouching system offers the latest technologies from ConvaTec, including:|/p| |ul| |li|A state-of-the art filter with anti-clogging film layer|/li| |li|Soft and quiet materials|/li| |li|The security of the InvisiClose™ tail closure with Lock-it Pocket™ ConvaTecs latest pouches and advanced adhesives offer you the security, comfort , and discretion you deserve.|/li| |/ul|
This is a compliance manual for flexible pouch defect identification and classification. It is intended as a reference manual for use by quality control and inspection personnel tasked to evaluate the integrity of flexible retort pouches.
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Enjoy free shipping on all purchases over $75 and free in-store pickup on the Charcoal Charger Accessory Pouch at The Container Store. Store and protect chargers, earbuds and cables when youre on the go. Our cotton pouch features a snap closure and a smooth lining that wont scratch devices. With its spring closure, just squeeze the Pocket to store your headphones or chargers in a snap. Sized to fit easily into a handbag, gym bag, backpack or carry-on tote, this cord organizer lets you identify items quickly and grab them easily so you can keep moving.
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The babies climb up the mothers fur and into her pouch where they find a teat. Some babies will not find their way to the pouch and will die. If they make it to the pouch, only babies who find one of the thirteen teats will survive. They will stay in the pouch and suckle for 55-60 days. Then they will move out of the pouch and spend another four to six weeks on their mothers back. In some parts of their range, females will have three litters a year ...
Loop is a nicotine-pouch factory based in Sweden. Though new on the market, they are known for their top-quality nicotine pouches. Their products come in the most environmentally friendly way, which makes them some of the best cigarette alternatives on the market. Their products are made from 50% plant-based ingredients and 50% recycled plastic. They […]. ...
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sejak ada pouch ni ke mana jer kami berjalan mesti adik akan dok dalamnya.. senang gitu adikpun macam selesa.. kaalu batrisyia ku boleh masukkan sekali, aku kumasukkan juga supaya dia tak berlegar ke merata tempat ...
I did have a question though. I am pre-op and currently cook for myself, husband, and 1yr old daughter. I struggle to buy small enough quantities to feed my family as it is, and I worry about how much worse it is going to get post-op. Renting an aparment= teeny tiny freezer. So, to get to the question part: what do you do with all your leftovers? Do you have specific places/ shopping methods that help you purchase in small enough quantities for your pouch? It seems like you eat a lot of variety but maybe you are using a lot of the same core ingredients? Thanks for any insight you can provide. ...
He also popularized the colonic j-pouch for patients with rectal cancer. The J-pouch, an alternative to a permanent ileostomy ... He introduced a popular modification to the technique for creating an ileo-anal pouch , or j-pouch for ulcerative colitis, in ... "Ileal pouch surgery for ulcerative colitis". World Journal of Gastroenterology. 13 (24): 3288-3300. doi:10.3748/wjg.v13. ...
... is when problems occur due to diverticulosis, a condition defined by the presence of pouches in the wall ... Colonic perforation due to diverticular disease may be classified using the Hinchey Classification. "Clinical manifestations ... and diagnosis of colonic diverticular disease". Literature review. "Diverticular Disease". www.niddk.nih.gov. September 2013. ...
Right-sided diverticula are micro-hernias of the colonic mucosa and submucosa through the colonic muscular layer where blood ... Having pouches in the large intestine that are not inflamed is known as diverticulosis. Inflammation occurs in between 10% and ... Diverticulitis, specifically colonic diverticulitis, is a gastrointestinal disease characterized by inflammation of abnormal ... Pemberton, John H (16 June 2016). "Colonic diverticulosis and diverticular disease: Epidemiology, risk factors, and ...
... differing in the fact that the pouching is below the cricopharyngeal muscle. Colonic diverticula: Although found incidentally ... The thymus appears in the form of two flask-shape diverticula, which arise from the third branchial pouch (pharyngeal pouch) of ... Note how the diverticula appear on either side of the longitudinal muscle bundle (taenium). Colonic diverticulum Diverticulum ... is an out-pouching(aneurysm) of the aorta where an aberrant right subclavian artery is located. It is unusual nomenclature, in ...
... colonic pouches MeSH E07.862.700 - skeletal muscle ventricle MeSH E07.862.705 - stomas MeSH E07.862.710 - surgical flaps MeSH ...
... colonic pouches MeSH A10.850.700 - skeletal muscle ventricle MeSH A10.850.705 - stomas MeSH A10.850.710 - surgical flaps MeSH ...
The cause of SCAD is unknown, but may be related to local colonic ischemia, fecal stasis, or mucosal prolapse. The factors that ... which spares the rectum and is associated with multiple sac-like protrusions or pouches in the wall of the colon ( ... Several factors may influence the development of the disease, such as local colonic ischemia, fecal stasis, or mucosal prolapse ... Colonoscopy shows erythema of the colonic mucosa, which may be characterized by friability and exudate. The descending and ...
Chronic disease Diverticulitis and diverticulosis result from an out pouching of the colonic mucosa, or gut wall, leading to a ...
"Clinical manifestations and diagnosis of colonic diverticular disease". Literature review.. *^ Stefánsson T, Ekbom A, Sparèn P ... Diverticulosis is the condition of having multiple pouches (diverticula) in the colon that are not inflamed. These are ... Most people with colonic diverticulosis are unaware of this structural change. When symptoms do appear in a person over 40 ... Diverticulosis is defined by the presence of multiple pouches (diverticula) in the colon.[18] In people without symptoms, these ...
Gore, R. (1992). "Colonic contour changes in chronic ulcerative colitis: Reappraisal of some old concepts". AJR. American ... The haustra (singular haustrum) of the colon are the small pouches caused by sacculation (sac formation), which give the colon ...
The pouches (diverticula) occur where there is a gap between or weakness within the muscle fibres of the bowel wall, ... in 1978 classifies a colonic perforation due to diverticular disease. The classification is I-IV: Hinchey I - localised abscess ... With age, all people develop out-pouching of the bowel wall as pressure from the inside of the bowel pushes the mucosa outwards ... para-colonic) Hinchey II - pelvic abscess Hinchey III - purulent peritonitis (the presence of pus in the abdominal cavity) ...
Depending on the type of surgery performed, the patient may still require periodic lower endoscopies to assess the pouch for ... Patients with toxic megacolon (colonic dilation > 6 cm and toxic appearing) who do not respond to steroid therapy within 72 ... destroying the hydroxyl and other radicals that may damage colonic epithelial barrier. 5-ASA may also be an inhibitor of TNF. ...
The pouch and flange (both one and two piece pouches) are usually changed every 2-5 days. Ostomy pouches fit close to the body ... and total colonic Hirschsprung's disease. An ileostomy may also be necessary in the treatment of colorectal cancer or ovarian ... Pouch leaks occurred in 11 patients, of these 7 have functioning pouches. Complications not related to the pouch itself ... and pouch fistulas (6.3%)); Of the 32 patients treated for valve slippage, 23 achieved a fully functioning pouch. Pouch or ...
It is also known as the colonic fluke, particularly when infecting other animals. Its natural habitat is the colon of pigs, and ... The alimentary canal is incomplete, consisting of a pair of lateral pouches arising from the oral sucker and a pharyngeal tube ... The incomplete alimentary canal consists of a pair of lateral pouches arising from the oral sucker and a slightly tortuous ...
Colonic transit studies may be used to rule out colonic inertia if there is a history of severe constipation. Continent ... Although a pouch of Douglas hernia, originating in the cul de sac of Douglas, may protrude from the anus (via the anterior ... and a hernia sac of peritoneum from the Pouch of Douglas and rectal wall can be seen. Other adjacent structures can sometimes ... anismus and colonic dysmotility exacerbate. Some believe that internal rectal intussusception represents the initial form of a ...
Diverticulosis occurs when pouches form on the intestinal wall. Once the pouches become inflamed it is known as diverticulitis ... Ghoshal, U. C.; Sengar, V.; Srivastava, D. (2012). "Colonic Transit Study Technique and Interpretation: Can These be Uniform ... In birds this is found as a pouch alongside the esophagus. Other animals including amphibians, birds, reptiles, and egg-laying ... ISBN 978-0-323-01639-1. Sarna, S.K. (2010). "Introduction". Colonic Motility: From Bench Side to Bedside. San Rafael, ...
Imperforate anus is an anus that ends in a blind pouch and does not connect to the rest of the person's intestines. Small left ... "Assessing colonic anatomy normal values based on air contrast enemas in children younger than 6 years". Pediatric Radiology. 47 ...
Human colonic mucosa is maintained by the colonic epithelial barrier and immune cells in the lamina propria (see intestinal ... The second step is a proctectomy and formation of the ileal pouch (commonly known as a "j-pouch"). This involves removing the ... Depending on the severity of the condition, pouch revision surgery may need to be performed. In some cased the pouch may need ... causing impaired colonic motility and leading to toxic megacolon. If the serous membrane is involved, a colonic perforation may ...
Mahjoub F, Kalantari M, Tabarzan N, Moradi B (October 2009). "Invading plant material appearing as a colonic tumoural mass in a ... a tobacco pouch and a magazine at the same time plastic tooth brush case Not all objects are solid. In 1987, a case was ... doi:10.1016/S0002-9610(41)90652-9. Roberge RJ, Squyres NS, MacMath TL (January 1988). "Popcorn primary colonic phytobezoar". ... Richter RM, Littman L (August 1975). "Endoscopic extraction of an unusual colonic foreign body". Gastrointestinal Endoscopy. 22 ...
Diverticula are small pouches that can form inside the bowel wall, which can become inflamed to give diverticulitis. This ... small bowel residence and colonic filling of a solid meal by the use of the gamma camera". Gut. 27 (3): 300-8. doi:10.1136/gut. ... The cecum is a pouch marking the division between the small intestine and the large intestine. It lies below the ileocecal ... At this junction is a mucosal fold called Hartmann's pouch, where gallstones commonly get stuck. The muscular layer of the body ...
S. Kyzer and P.H. Gordon: "The Stapled Functional End-to-End Anastomosis Following Colonic Resection. International Journal of ... intestinal pouches, and operations in the lowest parts of the pelvis. When U.S. Surgical Corporation's EEA circular stapler ... clinical Hunt-Lawrence and Paulino Roux-en-Y pouches using a stapling instrument, with Fernando Paulino in attendance. The ... Stapling Instruments Colo-Sigmoidectomy and Circular End-To-End Stapled Colo-Rectal Anastomosis Paulino Jejunal Pouch, Gastric ...
Diverticulosis occurs when pouches form on the intestinal wall. Once the pouches become inflamed it is known as diverticulitis ... Sarna, S.K. (2010). "Introduction". Colonic Motility: From Bench Side to Bedside. San Rafael, California: Morgan & Claypool ... In birds this is found as a pouch alongside the esophagus. Other animals including amphibians, birds, reptiles, and egg-laying ... "Commensal microbe-derived butyrate induces the differentiation of colonic regulatory T cells". Nature. 504 (7480): 446-450. doi ...
... but biopsy specimens must be examined under a microscope to determine whether cells are gastric or colonic in nature. Colonic ... "a pouch of stomach … drawn up by scar tissue into the mediastinum" ... representing an example of a "congenital short esophagus ...
At this junction is a mucosal fold called Hartmann's pouch, where gallstones commonly get stuck. The muscular layer of the body ... "Simultaneous measurement of gastric emptying, small bowel residence and colonic filling of a solid meal by the use of the ... The cecum is a pouch marking the division between the small intestine and the large intestine. It lies below the ileocecal ... Diverticula are small pouches that can form inside the bowel wall, which can become inflamed to give diverticulitis. This ...
Jul 2009). "Do preoperative factors predict subsequent diagnosis of Crohn's disease after ileal pouch-anal anastomosis for ... Functional colonic disease (IBS, Intestinal pseudoobstruction/Ogilvie syndrome) - Megacolon/Toxic megacolon · Diverticulitis/ ...
The patient may require an ileostomy (permanent stoma where stool goes into a bag on the abdomen) or have an ileo-anal pouch ... "Likely underdiagnosed, given the lower number of colonic polyps and lower risk for colorectal cancer compared to classic FAP". ... "Colectomy may be necessary, but in approximately one third of individuals the colonic polyps are limited enough in number that ... Most partial and whole APC deletions are associated with 100-2000 colonic adenomas, although attenuated FAP has been seen. ...
In such cases, a digital rectal examination elicits tenderness in the rectovesical pouch. Coughing causes point tenderness in ... Elderly: diverticulitis, intestinal obstruction, colonic carcinoma, mesenteric ischemia, leaking aortic aneurysm. The term " ... fecal retention in colonic reservoirs: a case control study". Surgical Infections. 8 (1): 55-62. doi:10.1089/sur.2005.04250. ...
... a part of the stomach is permanently stapled to create a smaller pre-stomach pouch, which serves as the new stomach.[30] ... The distal part of the small intestine is then connected to the pouch, bypassing the duodenum and jejunum. ... Weight loss is predominantly due to the restriction of nutrient intake that is created by the small gastric pouch and the ... or by resecting and re-routing the small intestine to a small stomach pouch (gastric bypass surgery). ...
... a part of the stomach is permanently stapled to create a smaller pre-stomach pouch, which serves as the new stomach.[33] ... The distal part of the small intestine is then connected to the pouch, bypassing the duodenum and jejunum. ... Weight loss is predominantly due to the restriction of nutrient intake that is created by the small gastric pouch and the ...
Colonic J-pouch is a type of neorectum, performed during surgery for rectal cancer. This may improve the quality of life of ... Colonic J-pouch is a type of neorectum, performed during surgery for rectal cancer. This may improve the quality of life of ... Comparison of Colonic J-pouch and Straight Coloanal anastomosis after Low Anterior Resection. Iran Red Crescent Med J. 2013;15 ...
A 5-cm colonic J pouch colo-anal reconstruction following anterior resection for low rectal cancer results in acceptable ... The aim of this study was to assess evacuation and continence in patients with a colon pouch, and to examine the impact of ... In 1998, all 102 surviving patients with a colon pouch, whose stoma had been closed for more than one year, were sent a postal ... A colon pouch has early functional benefits, although long-term function, especially evacuation, might mitigate against its ...
AIMS--To investigate colonic metaplasia of goblet and columnar epithelial cells in ileal pouch mucosa; to correlate this with ... Expression of colonic antigens by goblet and columnar epithelial cells in ileal pouch mucosa: their association with ... Expression of colonic antigens by goblet and columnar epithelial cells in ileal pouch mucosa: their association with ... One of eight (12%) pre-closure and 15 of 23 (65%) post-closure biopsy specimens stained with an antibody for colonic mucin. ...
Surveillance of the blind pouch is not currently recommended. Malignant infiltration of the colonic wall should be included in ... We present a case of a 68-year-old man with EWDA arising in the bypassed stomach that presented as a colonic pseudo-obstruction ... At autopsy the primary tumor was identified in the blind pouch of the bypassed stomach. A literature review on gastric EWDA and ... Pathologic examination showed metastatic EWDA in the colonic wall. Post-operative complications led to the patients demise. ...
He also popularized the colonic j-pouch for patients with rectal cancer. The J-pouch, an alternative to a permanent ileostomy ... He introduced a popular modification to the technique for creating an ileo-anal pouch , or j-pouch for ulcerative colitis, in ... "Ileal pouch surgery for ulcerative colitis". World Journal of Gastroenterology. 13 (24): 3288-3300. doi:10.3748/wjg.v13. ...
Colonic J-Pouch-Anal Anastomosis for Rectal Cancer. Dehni, Nidal; Parc, Rolland; Church, James M. ...
To describe, in the J-pouch reconstruction group, the feasibility of the colonic J-pouch. ... Percentage of the colonic J-pouch reconstruction performed with respect to the total number of patients selected for the J- ... Colonic J-Pouch Reconstruction Versus Straight Colorectal Anastomosis After Low Anterior Resection for Rectal Cancer: Impact on ... J-Pouch Colorectal Anastomosis or Straight Colorectal Anastomosis in Treating Patients With Rectal Cancer Who Have Undergone ...
Colonic Diseases. Intestinal Diseases. Pathologic Processes. Inflammatory Bowel Diseases. Amino-acid, glucose, and electrolyte ... Patients with ulcerative colitis operated with an ileal pouch-anal anastomosis (j-pouch) fall well into both these categories. ... Amino Acids in Ileal Pouch-anal Anastomosis for Ulcerative Colitis (AMINOPOUCH). This study is ongoing, but not recruiting ... With this study we hope to find evidence for anabolic effects of intravenous amino acids in j-pouch surgery for ulcerative ...
Patients with UC exhibit a unique transcriptomic response to ileal pouch creation that can be observed well before disease and ... The UC pouch, well before histologic inflammation, already displays a systems-level gain of colon-associated genes and loss of ... Background: Ulcerative colitis (UC) only involves the colonic mucosa. Yet, nearly 50% of patients with UC who undergo total ... Methods: We prospectively sampled pouch and prepouch ileum mucosal biopsies in patients with UC with ileal pouch anal ...
Diverticular disease is a group of conditions that affect your large intestine (colon). It involves small pouches or sacs, ...
Morbidity Following Coloanal Anastomosis: A Comparison of Colonic J-Pouch vs Straight Anastomosis. Brown, Shaun; Margolin, ...
Functional Outcome And Quality Of Life In Patients With Low Rectal Cancer After A J-pouch Or A Side-to- End Anastomosis ... Better Function With A Colonic J-pouch Or A Side-to-end Anastomosis? A Randomized Controlled Trial To Compare The Complications ... Better Function With A Colonic J-pouch Or A Side-to-end Anastomosis? A Randomized Controlled Trial To Compare The Complications ... Pouch necrosis was noted in 2(JP). QOL: QOL scores using either instrument were similar at 12 and 24 months(p,0.05) in both ...
Colonic Pouches*. Female. Humans. Ileum / surgery*. Male. Middle Aged. Pressure. Proctocolectomy, Restorative*. Quality of Life ... 9102269 - Is colonic electrical activity a similar phenomena to small-bowel electrical activity?. 8769279 - Effects of ... In 26 patients (54.17 percent of the cases), 10 males and 16 females, ileal pouch-anal anastomosis was performed after a ... Patients quality of life was improved for those undergoing the modified ileal pouch-anal anastomosis.. ...
Extensive colonic resection, subtotal or total colectomy. *Presence of ileostomies, colostomies or rectal pouches ... Diagnosis of Crohns disease for more than 4 months prior to Week -4 Visit, with small bowel and/or colonic involvement ... History of evidence of adenomatous colonic polyps that have not been removed. ...
Colonic J-pouch-anal anastomosis. Ileocecal reservoir. Sigmoid colon onlay patch (Bricker-Johnston) ...
To investigate changes in morbidity and mortality associated with ileal J-pouch surgery performed during the first 3 years of a ... Colonic Diseases / epidemiology, surgery*. Colonic Pouches / standards*. Education, Medical, Continuing / standards*. ... OBJECTIVE: To investigate changes in morbidity and mortality associated with ileal J-pouch surgery performed during the first 3 ... The results suggest that fellowship training and board certification conferred reasonable proficiency in J-pouch surgery before ...
Comparison between straight and colonic J-pouch anastomosis.. Hallböök O, Adrian TE, Permert J, Staab P. ... Enhancing release of peptide YY after near-total proctocolectomy: jejunal pouch vs. ileal pouch-distal rectal anastomosis. ... Morphological and immunohistochemical changes in intestinal mucosa and PYY release following total colectomy with ileal pouch- ...
Colonic Pouches * Cyclosporine / therapeutic use * Digestive System Surgical Procedures* / adverse effects * Drug Resistance ... While ileal pouch-anal anastomosis offers the prospect of life without a permanent ileostomy, there are issues with its long- ...
Rapid Incorporation of ω-3 Fatty Acids Into Colonic Tissue After Oral Supplementation in Patients With Colorectal Cancer: A ... Risk of postoperative morbidity in patients having bowel resection for colonic Crohns disease. Iesalnieks, I., Spinelli, A., ...
Diverticular disease is when problems occur due to diverticulosis, a condition defined by the presence of pouches in the wall ... Colonic perforation due to diverticular disease may be classified using the Hinchey Classification. "Clinical manifestations ... and diagnosis of colonic diverticular disease". Literature review. "Diverticular Disease". www.niddk.nih.gov. September 2013. ...
Right-sided diverticula are micro-hernias of the colonic mucosa and submucosa through the colonic muscular layer where blood ... Having pouches in the large intestine that are not inflamed is known as diverticulosis. Inflammation occurs in between 10% and ... Diverticulitis, specifically colonic diverticulitis, is a gastrointestinal disease characterized by inflammation of abnormal ... Pemberton, John H (16 June 2016). "Colonic diverticulosis and diverticular disease: Epidemiology, risk factors, and ...
Laparoscopic ultralow anterior resection with colonic J-pouch-anal anastomosis.. Selvindos PB, Ho YH. ...
I have colonic inertia. However, the doctor asked me about hirschsprung disease. I learned that part of my colon is under... ... Why would you need your rectum removed? Would you have a j pouch then? if not there is no reason to remove it.. Karen: 50 1997 ... I have colonic inertia. However, the doctor asked me about hirschsprung disease. I learned that part of my colon is under my ... I too had colonic inertia and had a total colectomy with ileorectal anastamosis 7 years ago. The surgeons also suggested I had ...
Berger A, Tiret E, Parc R,et al. Excision of the rectum with colonic J pouch-anal anastomosis for adenocarcinoma of the low and ... Compared with small pouches, a large pouch design does not lead to better neorectal compliance in the pig model, whereas pouch ... Wang J-Y, You Y-T, Chen H-H, Chiang J-M, Yeh C-Y, Tang R. Stapled colonic J-pouch-anal anastomosis without a diverting ... Kusunoki M, Shoji Y, Yanagi H,et al. Function after anoabdominal rectal resection and colonic J pouch-anal anastomosis. Br J ...
Diverticulitis - inflammation or infection of pouches in the colon. * Irritable bowel syndrome - an uncomfortable condition ... ClinicalTrials.gov: Colonic Diseases (National Institutes of Health) * ClinicalTrials.gov: Intestinal Diseases (National ... Treatment for colonic diseases varies greatly depending on the disease and its severity. Treatment may involve diet, medicines ... The primary NIH organization for research on Colonic Diseases is the National Institute of Diabetes and Digestive and Kidney ...
Pouches are for ulcerative colitis patients not colonic inertia patients. Barring any complications, pouches and ostomies are ... I have colonic inertia and after years of different treatment Im going to have a total colectomy. For as long as I can ... My ninth day there a nurse with a j-pouch came to speak with me about surgery. Everything I had ever heard about this surgery ... My GI was not in favor of the j-pouch surgery and I was not in favor of a permanent ileostomy. I met my surgeon who convinced ...
A J-pouch procedure involves an ileum to anal anastomosis with connected loops of folded ileum that form an internal reservoir. ... Total colonic aganglionosis, usually involving some distal ileum, is the most common. Rarely, the entire small bowel is also ... Colonic manometry in children with defecatory disorders. Role in diagnosis and management. Am J Gastroenterol. May 2003;98(5): ... Southwell B.R., Clarke M.C., Sutcliffe J., Hutson J.M.: Colonic transit studies: Normal values for adults and children with ...
"Clinical manifestations and diagnosis of colonic diverticular disease". Literature review.. *^ Stefánsson T, Ekbom A, Sparèn P ... Diverticulosis is the condition of having multiple pouches (diverticula) in the colon that are not inflamed. These are ... Most people with colonic diverticulosis are unaware of this structural change. When symptoms do appear in a person over 40 ... Diverticulosis is defined by the presence of multiple pouches (diverticula) in the colon.[18] In people without symptoms, these ...
"Ileo-Anal S-Pouch Reconstruction in Patients with Total Colonic Aganglionosis after Failed Pull-Through Procedure." Journal of ... Children with total colonic aganglionosis occasionally fail to benefit from a pull-through procedure. One option in treating ... This condition is known as total colonic aganglionosis, or TCA.. Hirschprungs disease occurs once in every 5,000 live births, ... these patients is the construction of an ileoanal S-pouch.. The surgeon may recommend a permanent ostomy if the child has Down ...
The anvil of the circular stapler is secured at the apex of the colonic pouch with a purse-string suture. The stapler is ... The colon is anastomosed to the rectum either as a straight colorectal anastomosis or as a colonic pouch-rectum anastomosis. ... The pouch is actually a short J pouch with a 6- to 8-cm limb; it owes its popularity to reports suggesting lesser stool ... Stapled division is ideal when a short colonic pouch-rectum anastomosis is considered. For a straight colorectal anastomosis, ...
  • METHODS--Biopsy specimens of ileal pouch mucosa were taken from 31 patients (30 with ulcerative colitis, one with familial adenomatous polyposis) either before (eight patients) or after (23 patients) ileostomy closure. (bmj.com)
  • He introduced a popular modification to the technique for creating an ileo-anal pouch , or j-pouch for ulcerative colitis, in which double stapling is used in place of sutures to improve results. (wikipedia.org)
  • Patients with ulcerative colitis operated with an ileal pouch-anal anastomosis (j-pouch) fall well into both these categories. (clinicaltrials.gov)
  • With this study we hope to find evidence for anabolic effects of intravenous amino acids in j-pouch surgery for ulcerative colitis. (clinicaltrials.gov)
  • Ulcerative colitis (UC) only involves the colonic mucosa. (nih.gov)
  • mean age, 35.52 years) with ulcerative colitis and familial adenomatous polyposis underwent ileal pouch-anal anastomosis after proctocolectomy in 1986 to 2002. (biomedsearch.com)
  • Pouchitis is the most frequent complication after ileal pouch-anal anastomosis for refractory ulcerative colitis. (springermedizin.de)
  • Data files of patients who underwent total proctocolectomy with ileal pouch-anal anastomosis for refractory ulcerative colitis and/or dysplasia from January 2007 to December 2014, with a follow-up until August 2015, were analyzed. (springermedizin.de)
  • Restorative surgery for ulcerative colitis with ileal pouch anal anastomosis (IPAA) is frequently accompanied by complications. (hindawi.com)
  • A 58-year-old woman who previously had undergone restorative proctocolectomy due to ulcerative colitis with an IPAA presented with volvulus of the pouch. (hindawi.com)
  • Ileal pouch anal anastomosis for ulcerative colitis is a complex surgical procedure frequently accompanied by short- and long-term complications [ 1 ]. (hindawi.com)
  • A 58-year-old woman operated with proctocolectomy and an ileal J-pouch 11 years earlier due to ulcerative colitis complicated by colonic cancer presented at a local hospital because of abdominal pain and failure of faecal evacuation. (hindawi.com)
  • Snape WJ Jr (1991) The role of a colonic motility disturbance in ulcerative colitis. (springer.com)
  • Greig E, Sandle GI (2000) Diarrhea in ulcerative colitis: the role of altered colonic sodium transport. (springer.com)
  • Coulie B, Camilleri M, Bharucha AE et al (2001) Colonic motility in chronic ulcerative proctosigmoiditis and the effects of nicotine on colonic motility in patients and healthy subjects. (springer.com)
  • Bassotti G, de Roberto G, Chistolini F et al (2004) Twenty-four-hour manometric study of colonic propulsive activity in patients with diarrhea due to inflammatory (ulcerative colitis) and non-inflammatory (irritable bowel syndrome) conditions. (springer.com)
  • Presents a letter to the editor about a case of prolapse of the pelvic ileal J-pouch after restorative proctocolectomy for ulcerative colitis. (ebscohost.com)
  • Twenty three quadruple loop ileal pouches constructed for ulcerative colitis (20 patients) and familial adenomatous polyposis (FAP) (three patients) were studied. (bmj.com)
  • Ulcerative colitis (UC) is a colonic inflammatory bowel disease (IBD) that occurs in young adults. (biomedcentral.com)
  • Diverticular disease is when problems occur due to diverticulosis, a condition defined by the presence of pouches in the wall of the large intestine (diverticula). (wikipedia.org)
  • Diverticulitis, specifically colonic diverticulitis, is a gastrointestinal disease characterized by inflammation of abnormal pouches-diverticula-which can develop in the wall of the large intestine. (wikipedia.org)
  • Right-sided diverticula are micro-hernias of the colonic mucosa and submucosa through the colonic muscular layer where blood vessels penetrate it. (wikipedia.org)
  • Diverticulosis is the condition of having multiple pouches ( diverticula ) in the colon that are not inflamed. (wikipedia.org)
  • Colonic diverticulosis is the presence of one or more diverticula in the colon. (merckmanuals.com)
  • People who have colonic diverticulosis usually have several diverticula. (merckmanuals.com)
  • In this slide show we will discuss colonic diverticula, which are bulging sacs that push outward on the colon wall. (emedicinehealth.com)
  • Ruge also reported that doctors found the president has asymptomatic colonic diverticula, meaning he has small pouches on the colon that are not inflamed and do not bother him. (washingtonpost.com)
  • Although it is the least common diverticulum of the gastrointestinal tract, GD has similar characteristics to duodenal, jejunal, and colonic diverticula [ 2 ]. (hindawi.com)
  • The colon can sometimes house diverticula , or pouches, within its tissue that become easily inflamed and infected by the bacteria-laden fecal matter that passes through. (wisegeek.com)
  • What is colonic diverticula? (brainscape.com)
  • Why would we only see colonic diverticula in the large intestine and not in the rectum? (brainscape.com)
  • What areas of the large intestine are even more susceptible to colonic diverticula? (brainscape.com)
  • Is a colonic diverticula a true diverticula or a false diverticula? (brainscape.com)
  • Diverticular disease is the term used to encompass a spectrum of issues from diverticulosis (the presence of sac-like pouches called diverticula that protrude from the colonic wall) to diverticulitis (the inflammation of these pouches and the accompanying symptoms). (chriskresser.com)
  • The term diverticulosis refers to the presence of diverticula due to the out-pouching of mucosa and muscularis mucosa through the muscularis propria at sites of vascular penetration. (dovepress.com)
  • If these pouches become inflamed by infection, the condition is known as Diverticulitis. (colon-cleanse-constipation.com)
  • Systematic Review and Meta-analysis on Colorectal Cancer Findings on Colonic Evaluation After CT-Confirmed Acute Diverticulitis. (amedeo.com)
  • When this pouch becomes infected or swollen, it is called diverticulitis. (epnet.com)
  • Diverticulitis - inflammation (swelling) or infections of diverticulosis pouches, located in the colon. (childrens.com)
  • Diverticulitis is a painful inflammatory condition caused by pus-filled pouches that line the walls of the large intestine or colon. (sandrarose.com)
  • Doctors caution diverticulitis sufferers from getting colonics or so-called colon cleansers. (sandrarose.com)
  • Colon strictures may be caused by an infection in colonic tissue, as occurs with diverticulitis . (wisegeek.com)
  • 2 ) The highest estimates suggest that approximately 20% of patients with diverticulosis (remember these are the people with the pouches, not the acute inflammation of the pouches) will at some point develop diverticulitis. (chriskresser.com)
  • Yet, nearly 50% of patients with UC who undergo total proctocolectomy with ileal pouch anal anastomosis develop UC-like inflammation of the ileal pouch (pouchitis). (nih.gov)
  • Function Outcome of Double-Stapled and Transanal Ileal Pouch-Anal Anastomosis after Proctocolectomy. (nii.ac.jp)
  • The aim of this study was to retrospectively evaluate the effect of sulfasalazine in primary prophylaxis of pouchitis after proctocolectomy with ileal pouch-anal anastomosis. (springermedizin.de)
  • Sulfasalazine may be potentially administered in pouchitis prophylaxis after proctocolectomy with ileal pouch-anal anastomosis, but large prospectively controlled trials are needed. (springermedizin.de)
  • A definition of the term "pouchitis," which refers to the inflammation of the pouch used in restorative proctocolectomy, is presented. (ebscohost.com)
  • Total Proctocolectomy and Heal Pouch Anal Anastomosis to Successfully Treat a Patient With Collagenous Colitis. (ebscohost.com)
  • Presents a letter to the editor about the application of total proctocolectomy and ileal pouch anal anastomosis to successfully treat a patient with collagenous colitis. (ebscohost.com)
  • Ileal neuroendocrine carcinoma following restorative proctocolectomy for colonic adenocarcinoma in Crohn's disease. (ebscohost.com)
  • A letter to the editor is presented that discusses the diagnosis of ileal neuroendocrine carcinoma following restorative proctocolectomy for colonic adenocarcinoma in Crohn's disease. (ebscohost.com)
  • Transabdominal repair of prolapsed pelvic ileal J-pouch after restorative proctocolectomy. (ebscohost.com)
  • Re: Surgical treatment of severe colonic inertia with restorative proctocolectomy. (ebscohost.com)
  • Presents a response to a letter to the editor about the author's article "Surgical Treatment of Severe Colonic Inertia with Restorative Proctocolectomy. (ebscohost.com)
  • The article presents a definition for the term "pouchitis," which refers to acute or chronic inflammation of the surgically produced pouch used in restorative proctocolectomy. (ebscohost.com)
  • Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the gold standard surgery in familial adenomatous polyposis (FAP), UC, and IBD unclassified (IBDU), another colonic IBD formerly called indeterminate colitis [ 4 ]. (biomedcentral.com)
  • Colonic J-pouch is a type of neorectum , performed during surgery for rectal cancer. (radiopaedia.org)
  • He also popularized the colonic j-pouch for patients with rectal cancer. (wikipedia.org)
  • RATIONALE: It is not yet known whether a J-pouch colorectal anastomosis is more effective than a straight colorectal anastomosis in treating patients with rectal cancer who have undergone surgery to remove the tumor. (clinicaltrials.gov)
  • PURPOSE: This randomized clinical trial is studying J-pouch colorectal anastomosis to see how well it works compared with straight colorectal anastomosis in treating patients with rectal cancer who have undergone surgery to remove the tumor. (clinicaltrials.gov)
  • To assess whether the incidence of major anastomotic leak after low anterior resection, in patients with rectal cancer, is reduced by using the J-pouch reconstruction vs straight colorectal anastomosis. (clinicaltrials.gov)
  • Functional outcome after low anterior resection with low anastomosis for rectal cancer using the colonic J-pouch: prospective randomized study for determination of optimum pouch size. (springer.com)
  • Seow-Choen F. Colonic pouches in the treatment of low rectal cancer. (springer.com)
  • Dr. Wexner was the first surgeon in the USA to publish the study of the colonic J-pouch for rectal cancer. (cbj.ca)
  • Colonic perforation due to diverticular disease may be classified using the Hinchey Classification. (wikipedia.org)
  • Complications of colonic diverticular disease are more common in people who smoke, are obese, or use NSAIDs. (merckmanuals.com)
  • Diverticular disease is the presence of out pouches of usually the colonic mucosa. (healthtap.com)
  • These are outpockets of the colonic mucosa and submucosa through weaknesses of muscle layers in the colon wall. (wikipedia.org)
  • Inflammatory change was estimated using an established scoring system for pouchitis, and acquisition of colonic antigens was determined by immunohistochemistry using three monoclonal antibodies which recognise components of the two major epithelial cell types in the colorectum. (bmj.com)
  • By contrast, patients with familial adenomatous polyposis (FAP) with ileal pouch anal anastomosis develop pouchitis far less frequently. (nih.gov)
  • Patients with UC exhibit a unique transcriptomic response to ileal pouch creation that can be observed well before disease and may in part explain their susceptibility to the development of pouchitis. (nih.gov)
  • Pouchitis following ileal pouch-anal anastomosis: definition, pathogenesis, and treatment. (springermedizin.de)
  • Our results suggest, however, that there may not be complete colonic metaplasia and that the mucin changes and other phenotypic alterations may represent a non-specific response to pouch inflammation and not a prerequisite for the development of pouchitis. (bmj.com)
  • A 2-year longitudinal microbiome study of 22 patients who underwent colectomy with an ileal pouch anal anastomosis detected significant increases in distinct populations of Bacteroides during 9 of 11 patient visits that coincided with inflammation (pouchitis). (asm.org)
  • Expression of colonic antigens by goblet and columnar epithelial cells in ileal pouch mucosa: their association with inflammatory change and faecal stasis. (bmj.com)
  • Functional pathway analysis of differentially expressed genes in the UC pouch revealed an enhanced state of immune/inflammatory response and extracellular matrix remodeling. (nih.gov)
  • He completed a one year fellowship in Edinburgh colorectal unit to gain specialist training in the management of complex colorectal cancer, inflammatory bowel disease and ileo-anal pouch surgery. (nuffieldhealth.com)
  • The mucosa associated colonic microflora of 57 patients with active inflammatory bowel disease and 46 controls was investigated using 16S rDNA based single strand conformation polymorphism (SSCP) fingerprint, cloning experiments, and real time polymerase chain reaction (PCR). (bmj.com)
  • There is no quality evidence of the benefit of defunctioning ileostomy (DI) in ileal pouch-anal anastomoses (IPAAs) performed for inflammatory bowel disease (IBD), but most surgical teams currently resort to DI. (biomedcentral.com)
  • Indeed, this procedure is the only treatment that eliminates both inflammatory and oncologic risks in the colonic and rectal segments. (biomedcentral.com)
  • During my previous consultant jobs at The Royal Marsden, St Mark's and Hinchingbrooke hospitals, I followed the enhanced recovery programme, performed new procedures like TEO/TEMS, HALO and have been performing laparoscopic and open surgery for primary and advanced colorectal cancers, surgery for inflammatory bowel disease and Pouch surgery. (spirehealthcare.com)
  • We prospectively sampled pouch and prepouch ileum mucosal biopsies in patients with UC with ileal pouch anal anastomosis 4, 8, and 12 months after their pouch was in continuity. (nih.gov)
  • Anal canal pressure after ileal pouch-anal anastomosis with strengthened internal anal sphincter. (biomedsearch.com)
  • In 26 patients (54.17 percent of the cases), 10 males and 16 females, ileal pouch-anal anastomosis was performed after a modified surgical technique for strengthening the internal anal sphincter by creation of a smooth muscle cuff through plication of a mucosectomized segment of residual rectum. (biomedsearch.com)
  • This effect was absent after the standard ileal pouch-anal anastomosis. (biomedsearch.com)
  • CONCLUSIONS: We concluded that ileal pouch-anal anastomosis with rectal plication perhaps improved sphincter function. (biomedsearch.com)
  • Patients quality of life was improved for those undergoing the modified ileal pouch-anal anastomosis. (biomedsearch.com)
  • Morphological and immunohistochemical changes in intestinal mucosa and PYY release following total colectomy with ileal pouch-anal anastomosis in dogs. (nih.gov)
  • While ileal pouch-anal anastomosis offers the prospect of life without a permanent ileostomy, there are issues with its long-term functional outcome. (nih.gov)
  • Lazorthes F, Fages P, Chiotasso P, Lemozy J, Bloom E. Resection of the rectum with construction of a colonic reservoir and colo-anal anastomosis for carcinoma of the rectum. (springer.com)
  • Prospective randomized trial comparing J colonic pouch-anal anastomosis and straight coloanal reconstruction. (springer.com)
  • Kusunoki M, Yanagi H, Shoji Y, Yamamura T, Utsunomiya J. Abdominal rectal resection and colonic J pouch-anal anastomosis: 10 years' experience. (springer.com)
  • Excision of the rectum with colonic J pouch-anal anastomosis for adenocarcinoma of the low and mid rectum. (springer.com)
  • This pouch mimics the function of the rectum and preserves anal function. (wellmont.org)
  • Colonic transformation of ileal pouch-anal anastomosis and of the distal ileum: MRI findings. (uzh.ch)
  • A trans-anal specimen extraction was performed and a colonic pouch rectal anastomosis was created that appeared to have good blood supply by the operating surgeon. (sages.org)
  • Is diverting loop ileostomy necessary for completion proctectomy with ileal pouch-anal anastomosis? (biomedcentral.com)
  • Comparison of Colonic J-pouch and Straight Coloanal anastomosis after Low Anterior Resection. (radiopaedia.org)
  • CONCLUSION: Coloanal J-pouch reconstruction adequately restores reservoir capacity after low anterior resection of the rectum. (springer.com)
  • Hallböök O, Påhlman L, Krog M, Wexner SD, Sjödahl R. Randomized comparison of straight and colonic J pouch anastomosis after low anterior resection. (springer.com)
  • Better Function With A Colonic J-pouch Or A Side-to-end Anastomosis? (americansurgical.org)
  • Several surgical techniques (Colonic J pouch, transverse coloplasty and side-to-end anastomosis) have been created as alternatives to the standard straight coloanal anastomosis. (cochrane.org)
  • The colonic J pouch, side-to-end anastomosis and transverse coloplasty have been developed as alternative surgical strategies in order to improve bowel function. (cochrane.org)
  • Having pouches in the large intestine that are not inflamed is known as diverticulosis. (wikipedia.org)
  • These pouches usually affect only the large intestine but sometimes they occur in the small intestine as well. (colon-cleanse-constipation.com)
  • A pouch that forms in the wall of the large intestine is called a diverticulum. (epnet.com)
  • CONCLUSIONS--Both goblet and columnar cells acquire colonic characteristics which are incomplete, but may represent a true adaptive response as they can develop in the absence of inflammation. (bmj.com)
  • The UC pouch, well before histologic inflammation, already displays a systems-level gain of colon-associated genes and loss of ileum-associated genes. (nih.gov)
  • Approaches may range from dietary changes to the use of drug therapy and, in some cases, surgery to alleviate colonic inflammation. (wisegeek.com)
  • Another factor that commonly contributes to colonic stricture is chronic inflammation. (wisegeek.com)
  • Crohn's disease is an autoimmune disease where the body's immune system attacks healthy colonic tissue resulting in extensive inflammation. (wisegeek.com)
  • The chronic inflammation causes a narrowing of the colonic passage that impairs bowel function. (wisegeek.com)
  • Being strictured at the J pouch inlet doesn't help, but I am told my pattern is scattered ulcerations in the neoterminal ileum, which doesn't correspond neatly with backsplash stool- hence my Crohn's Diagnosis, because of the location and pattern of the inflammation. (j-pouch.org)
  • Most people with colonic diverticulosis are unaware of this structural change. (wikipedia.org)
  • The etiology of colonic diverticulosis is multifactorial and not entirely known. (merckmanuals.com)
  • Doctors' $100 word for that is diverticulum and troublesome colonic "tics" is diverticulosis. (aopa.org)
  • Colonic diverticulosis is an increasingly common condition in the aging western population. (dovepress.com)
  • A second method is called colonic irrigation or colon hydrotherapy, in which a practitioner flushes out the colon by sending gallons of water into the body through a tube inserted into a person's rectum. (livescience.com)
  • The laparoscopic NIRF system was utilized to evaluate the perfusion of the colonic pouch rectal anastomosis and the proximal colon was found to have no perfusion with good perfusion in the remaining rectum. (sages.org)
  • Sharon's surgery involved removing the cancerous tumor near her rectum, and then performing a coloanal anastomosis, with the addition of a 'colonic J-pouch' to improve frequency,' describes Dr. Wolff. (fascrs.org)
  • The 'colonic J pouch' procedure is a recent advance in colorectal surgery that enables patients to have less frequent bowel movements after removal of the rectum. (fascrs.org)
  • Excision of the rectum and anus (panproctocolectomy) would add considerable time to the procedure and remove the possibility of creating a pouch in the future. (brainscape.com)
  • Segmental Colonic Resection Is a Safe and Effective Treatment Option for Colon Cancer of the Splenic Flexure: A Nationwide Retrospective Study of the Italian Society of Surgical Oncology-Colorectal Cancer Network Collaborative Group. (amedeo.com)
  • OBJECTIVE: To investigate changes in morbidity and mortality associated with ileal J-pouch surgery performed during the first 3 years of a single surgeon's practice to determine the presence or absence of a learning curve after fellowship training. (biomedsearch.com)
  • Although certain functional aspects are improved with coloanal J-pouch anastomosis, evacuation difficulties are encountered in some of these patients. (springer.com)
  • METHODS: Thirty-two adult Göttinger mini pigs were randomly assigned either to straight end-to-end (Group 1), side-to-end (Group 2), small (4-cm limb length) J-pouch (Group 3), or large (8-cm limb length) J-pouch (Group 4) coloanal anastomosis after low rectal excision. (springer.com)
  • Ortiz H, De Miguel M, Armendariz P, Rodriguez J, Chocarro C. Coloanal anastomosis: are functional results better with a pouch? (springer.com)
  • Lazorthes F, Chiotasso P, Gamagami RA, Istvan G, Chevreau P. Late clinical outcome in a randomized prospective comparison of colonic J pouch and straight coloanal anastomosis. (springer.com)
  • Gross E, Amir-Kabirian H. Coloanal J-pouch following total rectal resection. (springer.com)
  • Coloanal anastomosis with intersphincteric resection and colon J-pouch construction. (wisepress.com)
  • Arm II: Patients undergo a total mesorectal excision with a low anterior rectal resection followed by a mechanical J-pouch stapled anastomosis reconstruction. (clinicaltrials.gov)
  • Transcriptional profiles of the UC and FAP pouch and prepouch ileum were investigated via RNA sequencing and compared with data from a previously published microarray study. (nih.gov)
  • Unlike patients with FAP, subjects with UC exhibited a large set of differentially expressed genes between the pouch and prepouch ileum as early as 4 months after pouch functionalization. (nih.gov)
  • A small pouch is made from the ileum to store stool. (wellmont.org)
  • A loop of the distal ileum was also found to be twisted behind the mesentery of the afferent loop of the pouch as a remaining part of the volvulus (Figure 2 ). (hindawi.com)
  • Impact of hospital case volume on short-term outcome after laparoscopic operation for colonic cancer. (springer.com)
  • Bassotti G, Germani U, Morelli A (1995) Human colonic motility: physiological aspects. (springer.com)
  • Carcinoembryonic antigen, as measured by radioimmunoassay, is present in two different human colonic tumors that have been serially transplanted and maintained in the cheek pouches of unconditioned, adult golden hamsters. (sciencemag.org)
  • This study addresses the hypothesis that pANCA identifies an antigen(s) expressed by bacteria resident in the human colonic mucosa. (asm.org)
  • in some cases, severe colonic strictures can necessitate the removal of the entire colon. (wisegeek.com)
  • Compared with small pouches, a large pouch design does not lead to better neorectal compliance in the pig model, whereas pouch evacuation seems to be considerably compromised. (springer.com)
  • A diverticulum is a bulging pouch or sac that can form on internal organs. (emedicinehealth.com)
  • The perspective is a potential for primary prophylaxis of surgical complications, reduction in the length of hospitalization, and subsequently optimized long-term functional outcome of the pouch. (clinicaltrials.gov)
  • Volvulus of the ileal pouch is one of the most rarely reported late complications and to our knowledge no report exists on reoperative surgery for this condition. (hindawi.com)
  • Uncommon complications of pouch surgery include afferent loop syndrome and prolapse [ 3 , 4 ]. (hindawi.com)
  • Several studies have suggested a correlation with environmental factors (eg, a diet low in fiber or high in red meat), heritable factors, and alterations in the colonic wall structure and motility. (merckmanuals.com)
  • Bazzocchi G, Ellis J, Villanueva-Meyer J et al (1991) Effect of eating on colonic motility and transit in patients with functional diarrhea. (springer.com)
  • I have colonic inertia and after years of different treatment I'm going to have a total colectomy. (healingwell.com)
  • Although I cannot relate to the colonic inertia aspect of your difficulties I can relate to the not having a normal life from day to day. (healingwell.com)
  • I have colonic inertia. (healingwell.com)
  • There are plenty of folk who have been on here before with colonic inertia but dont visit here as much now, but i am one of them. (healingwell.com)
  • It will take a few months to recover but it is worth it after suffering with colonic inertia etc. (healingwell.com)
  • Understanding New Concepts: Clostridium difficile Infection in Pouch Patients. (ebscohost.com)
  • The swelling causes the abdominal sack, or pouch to rupture or tear, and this leads to an infection of the colonic tissues. (mightyguide.net)
  • However, on the same day as she had been discharged, she presented as an emergency case at our hospital with identical symptoms of obstruction and was admitted to a surgical ward after the application of a tube into the pouch for deflating. (hindawi.com)
  • This has led to the thought that increased pressure causes these pouches or sacs. (druginfonet.com)
  • A condition marked by small sacs or pouches in the walls of a hollow organ, such as the colon. (icd10data.com)
  • The J-pouch, an alternative to a permanent ileostomy or colostomy, allows patients who have had their colons removed to continue to have regular bowel movements without an ostomy bag. (wikipedia.org)
  • There are varying types of ostomy pouches and ostomy skin barriers available to provide support and pep up your colostomy supplies, urostomy supplies and ileostomy supplies. (healthproductsforyou.com)
  • Right hemicolectomy was performed with terminal ileostomy and distal closure using Hartman s pouch procedure. (medigraphic.com)
  • The colonic pouch rectal anastomosis was taken down, additional transverse colon was mobilized, and a hand sewn colo-rectal anastomosis was performed with a diverting ileostomy. (sages.org)
  • A temporary loop ileostomy was performed to allow the J-pouch to heal before using it. (fascrs.org)
  • The pouch is diverted by a defunctioning ileostomy, which is closed in the third stage 6 to 8 weeks later. (biomedcentral.com)
  • We present a case of a 68-year-old man with EWDA arising in the bypassed stomach that presented as a colonic pseudo-obstruction (CPO). (openarchives.gr)
  • A CT-scan aroused suspicion of twisting of the pouch along its longitudinal axis causing an obstruction at the ileoanal anastomosis. (hindawi.com)
  • To do this, I turned the colon around on itself and created a pouch shaped like a 'J' that would eventually prevent the need for a colostomy bag. (fascrs.org)
  • Methods: Nine patients with UC had colonic biopsy specimens taken during a symptomatic flare that coincided with positive C difficile (C difficile+) tests. (ebscohost.com)
  • This condition is known as total colonic aganglionosis, or TCA. (encyclopedia.com)
  • Distribution of mucosal pathology and an assessment of colonic phenotypic change in the pelvic ileal reservoir. (bmj.com)
  • This first report ever on reoperative surgery for volvulus of a pelvic pouch indicates that a single row pouchopexy might be insufficient for preventing retwisting. (hindawi.com)
  • A finding indicating the presence of multiple pouches, usually in the colonic or gastric wall. (icd10data.com)
  • A gastric diverticulum is a pouch protruding from the gastric wall. (hindawi.com)
  • A gastric diverticulum (GD) is a pouch protruding from the gastric wall, first described by Moebius in 1661 and later by Roax in 1774 [ 1 ]. (hindawi.com)
  • An intestinal tube was passed into the pouch for decompression which resulted in relief of symptoms lasting also the day after removal of the tube. (hindawi.com)
  • Repeated CT-scans at presentation and after application of the tube showed again volvulus of the pouch, which resolved after tube insertion as did the symptoms (Figure 1 ). (hindawi.com)
  • An iatrogenic duodenal perforation during a diagnostic procedure led to an emergent exploratory laparotomy in which the dilated colonic segment was resected. (openarchives.gr)
  • This pressure increases and pushes along the sidewalls of the bowel creating pouches. (epnet.com)
  • Volvulus of the small bowel including the pouch or isolated volvulus of the pouch is rarely described [ 5 - 8 ]. (hindawi.com)
  • It collects in a pouch called an ostomy bag. (wellmont.org)
  • The basic requirement in ostomy products is an ostomy skin barrier and a collection pouch. (healthproductsforyou.com)
  • In a one-piece ostomy system , the ostomy pouch and ostomy skin barrier are joined and sold as a single piece. (healthproductsforyou.com)
  • The one-piece ostomy system makes convenient ostomy supplies for those with dexterity limitations because there is no need for frequent fixing of ostomy pouch to barrier. (healthproductsforyou.com)
  • People who have a permanent colostomy are fitted with an ostomy pouching system. (mskcc.org)
  • Libraries of colonic bacteria were generated using aerobic and anaerobic microbiologic culture conditions, and bacterial pools and clonal isolates were evaluated for cross-reactive antigens by immunoblot analysis using the pANCA monoclonal antibody Fab 5-3. (asm.org)
  • These findings demonstrate that a pANCA monoclonal antibody detects a recurrent protein epitope expressed by colonic bacteria and implicates colonic bacterial proteins as a target of the disease-associated immune response. (asm.org)
  • One of eight (12%) pre-closure and 15 of 23 (65%) post-closure biopsy specimens stained with an antibody for colonic mucin. (bmj.com)
  • Ninety six per cent of pouches showed some colonic phenotypic expression as defined by mucin histochemical and PR 3A5 immunohistochemical studies. (bmj.com)