{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:02:43Z","timestamp":1777921363667,"version":"3.51.4"},"reference-count":17,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T00:00:00Z","timestamp":1569888000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Laparoendoscopic &amp; Advanced Surgical Techniques"],"published-print":{"date-parts":[[2019,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>Restoration of intestinal continuity by ileal pouch-anal anastomosis (IPAA) following subtotal colectomy may not require a temporary, protective ileostomy. Diversion contributes to patient discomfort, cost, and additional operative risk at the time of subsequent reversal. We compared the outcomes of pediatric patients undergoing modified two-stage to three-stage IPAA after recovering from subtotal colectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We reviewed children (age &lt;18) who underwent IPAA creation for ulcerative or indeterminate colitis from January 1, 2007 to December 31, 2017. Patient characteristics, operative details, 30-day complications, and postoperative length of stay (LOS) were abstracted. Total LOS for the three-stage group included both the IPAA and the ileostomy reversal operations. Univariate comparisons between patients undergoing modified two-stage and three-stage operations were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 43 patients underwent IPAA after subtotal colectomy; 32 (74%) underwent a three-stage approach, and 11 (26%) had a modified two-stage approach. Operative approach was laparoscopic in 33 (77%), planned open in 9 (21%), and converted to open in 1 (2%). Single-incision technique was used in 12 of 33 (36%) laparoscopic cases. Modified two-stage procedures had shorter total median LOS (7 days versus 9 days,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.005). Incidence of postoperative leak, readmission, return to the operating room, and maximum 30-day Clavien\u2013Dindo scores at the time of IPAA creation did not differ between modified two- and three-stage approaches (all\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&gt;\u2009.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The modified two-stage approach to IPAA creation resulted in fewer hospital days compared to the three-stage approach. Considering the risks and patient burdens of diversion, further research is needed to assist in decisions regarding protective ileostomy after completion proctectomy with IPAA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/lap.2019.0106","type":"journal-article","created":{"date-parts":[[2019,8,13]],"date-time":"2019-08-13T12:04:42Z","timestamp":1565697882000},"page":"1207-1211","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["Altering the Traditional Approach to Restorative Proctocolectomy After Subtotal Colectomy in Pediatric Patients"],"prefix":"10.1177","volume":"29","author":[{"suffix":"Jr.","given":"Michael D.","family":"Traynor","sequence":"first","affiliation":[{"name":"Department of Surgery, Mayo Clinic, Rochester, Minnesota."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Yonkus","sequence":"additional","affiliation":[{"name":"Department of Surgery, Mayo Clinic, Rochester, Minnesota."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher R.","family":"Moir","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, Mayo Clinic, Rochester, Minnesota."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denise B.","family":"Klinkner","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, Mayo Clinic, Rochester, Minnesota."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr.","given":"D. Dean","family":"Potter","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, Mayo Clinic, Rochester, Minnesota."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,10,14]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1089\/lap.2014.0297"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2018.10.005"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2015.03.044"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000236"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2011.10.042"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/2013.jamasurg.325"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1503\/cjs.001610"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2010.09.085"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-004-0848-9"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2016.12.049"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.143.4.406"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(99)90383-4"},{"key":"e_1_3_3_14_2","article-title":"Outcomes following two-stage surgical approaches in the treatment of pediatric ulcerative colitis","author":"Bismar N","year":"2018","unstructured":"Bismar N, , Knod JL, , Patel AS, , Schindel DT. Outcomes following two-stage surgical approaches in the treatment of pediatric ulcerative colitis. J Pediatr Surg October 2018 [Epub ahead of print]; DOI: 10.1016\/j.jpedsurg.2018.09.021.","journal-title":"J Pediatr Surg"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-019-04440-1"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199010000-00007"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjw069"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.SMJ.0000047720.97917.03"}],"container-title":["Journal of Laparoendoscopic &amp; Advanced Surgical Techniques"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/lap.2019.0106","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/lap.2019.0106","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/lap.2019.0106","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T19:52:36Z","timestamp":1777665156000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/lap.2019.0106"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,1]]},"references-count":17,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2019,10,1]]}},"alternative-id":["10.1089\/lap.2019.0106"],"URL":"https:\/\/doi.org\/10.1089\/lap.2019.0106","relation":{},"ISSN":["1092-6429","1557-9034"],"issn-type":[{"value":"1092-6429","type":"print"},{"value":"1557-9034","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,1]]}}}