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Surgical management of a long efferent loop after J-pouch ileoanal reconstruction
P J Klingler1, S A Branton, N R Floch
1Department of Surgery, Mayo Clinic Jacksonville, Florida 32224, USA.
Purpose:
To demonstrate a simple and effective repair of a poorly constructed ileal J-pouch with an extensive long efferent limb.
Method:
A retrospective case review was performed.
Results:
The surgical procedure described preserves additional ileum and enlarges the ileal reservoir. The procedure succeeded in resolving the patient's complaints of partial obstruction, weight loss, and increased stool frequency. At five-month follow-up, the patient was doing well with three to six stools daily. Evaluation of the new ileal J-pouch showed no signs of inflammation, and the pouch size measured more than 20 cm compared with 12 cm preoperatively.
Conclusions:
Repair of a long efferent limb by this simple stapling technique is feasible, simple, and effective, with an excellent clinical result. It preserves valuable small intestine and enlarges the capacity of the reservoir, leading to better functional outcome.