Valerio Celentano is Consultant Colorectal Surgeon at Chelsea & Westminster Hospital NHS Foundation Trust, and Head of J-Pouch One Stop Clinic at Chelsea & Westminster Hospital. Ileal pouch-anal anastomosis (IPAA) after total proctocolectomy (removal of entire large bowel and rectum) is a surgical procedure for ulcerative colitis refractory to medical treatment and majority of patients with familial adenomatous polyposis (FAP), as an alternative to permanent end ileostomy.
Although many patients undergoing pouch surgery have satisfactory functional and long-term outcomes results, the procedure is complex and associated with problems and complications in the short- and long-term. Several complications following pouch surgery can lead to the pouch requiring removal (pouch excision) or permanent diversion (need for ileostomy) and reported rates can be up to 20%. This spectrum of conditions carries the very unfortunate and likely inappropriate name of “pouch failure”. Gaining experience in pouch surgery is hard as the procedure is performed infrequently across many hospitals, as reported by the UK Pouch registry, outlining that the average number of pouches performed in English institutions was low and one quarter of the surgeons undertaking this operation had performed only one case over the last five years. The interactive talk will discuss the challenges of ileoanal pouch surgery and some of the surgical complications that can benefit from revisional (redo) pouch surgery.
An institutional initiative to promote standardisation of multidisciplinary care in IPAA surgery will also be presented. Contact Details:
For Valerio Celentano and Chelsea & Westminster web: www.chelwest.nhs.uk/ibd-surgery-centre
This video was recorded on behalf of the Red Lion Group on 9 March 2023.