{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T13:27:59Z","timestamp":1762867679017,"version":"3.40.5"},"reference-count":17,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,3,2]],"date-time":"2019-03-02T00:00:00Z","timestamp":1551484800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Many surgeons consider total proctectomy with ileal pouch\u2013anal anastomosis as the treatment of choice for patients with medically refractory ulcerative colitis or ulcerative colitis with dysplasia. However, obstruction occurring at the pouch inlet or involving the afferent limb can be refractory to nonoperative or endoscopic management. Historically, these refractory obstructions have usually required resection of the pouch. There is now increasing evidence to suggest that pouch salvage surgery may be feasible in these patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review was performed of all patients of a single surgical practice who underwent a neo ileal\u2010pouch anastomosis for J\u2010pouch inlet obstructions between 2000 and 2017. Data collected included patient demographics, preoperative workup, intra\u2010operative findings, type of surgical intervention and postoperative outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Surgical interventions were performed on eight patients with J\u2010pouch inlet obstructions. Six patients had inlet strictures or acute angulations at the inlet, which were either bypassed or resected and primarily\u00a0anastomosed. Two patients had internal hernias posterior to the mesentery, with volvulus of the pouch. At a mean follow\u2010up of 36.5\u00a0months, all patients retained their pouches and the mean number of daily bowel movements was eight. Two major and two minor complications occurred.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>J\u2010pouch inlet obstructions may take years to develop. In patients with obstruction who are refractory to endoscopic or medical treatment, good functional results may be obtained with pouch salvage procedures. With increasing numbers of J\u2010pouches being performed, awareness of novel surgical techniques is important.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.14574","type":"journal-article","created":{"date-parts":[[2019,2,1]],"date-time":"2019-02-01T01:35:12Z","timestamp":1548984912000},"page":"679-683","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Surgical solutions for refractory J\u2010pouch inlet obstruction"],"prefix":"10.1111","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2539-9903","authenticated-orcid":false,"given":"M. M.","family":"Sellers","sequence":"first","affiliation":[{"name":"Department of Surgery Icahn School of Medicine at Mount Sinai New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B. M.","family":"Elnekaveh","sequence":"additional","affiliation":[{"name":"Department of Surgery Icahn School of Medicine at Mount Sinai New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. J.","family":"Hahn","sequence":"additional","affiliation":[{"name":"Department of Surgery Icahn School of Medicine at Mount Sinai New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. P.","family":"Hirten","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Icahn School of Medicine at Mount Sinai New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. J.","family":"Greenstein","sequence":"additional","affiliation":[{"name":"Department of Surgery Icahn School of Medicine at Mount Sinai New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,3,2]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-200202000-00007"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MIB.0000000000000086"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2007.11.006"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.21503"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.21644"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800830324"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02055376"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.5242"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2017.11.011"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001386"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02055380"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-016-1307-7"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-012-1872-z"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.22933"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/DCR.0b013e3181fc9f04"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjw072"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.20661"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcodi.14574","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.14574","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/codi.14574","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.14574","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T13:53:38Z","timestamp":1694354018000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.14574"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,2]]},"references-count":17,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2019,6]]}},"alternative-id":["10.1111\/codi.14574"],"URL":"https:\/\/doi.org\/10.1111\/codi.14574","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"type":"print","value":"1462-8910"},{"type":"electronic","value":"1463-1318"}],"subject":[],"published":{"date-parts":[[2019,3,2]]},"assertion":[{"value":"2018-09-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-01-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-03-02","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}