title: Surgical management of a long efferent loop after J-pouch ileoanal reconstruction.
abstract: OBJECTIVE
  To demonstrate a simple and effective repair of a poorly constructed ileal J-pouch with an extensive long efferent limb.
  
  
  METHODS
  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.
authors.affiliation: Department of Surgery, Mayo Clinic Jacksonville, Florida 32224, USA.
authors.forename: P J
authors.initials: PJ
authors.lastname: Klingler
authors.forename: S A
authors.initials: SA
authors.lastname: Branton
authors.forename: N R
authors.initials: NR
authors.lastname: Floch
authors.forename: P P
authors.initials: PP
authors.lastname: Metzger
mesh_terms: D000293:Adolescent; D001466:Barium Sulfate; D004733:Enema; D005260:Female; D006801:Humans; D016737:Proctocolectomy, Restorative / Q000009:adverse effects*; D012086:Reoperation / Q000379:methods*
chemical_list: D001466:Barium Sulfate