Modified 2-stage IPAA has similar postoperative complication rates and functional outcomes compared to 3-stage IPAA

INTRODUCTION

Reconstructive ileal-pouch anal anastomosis (IPAA) for ulcerative colitis (UC) is often created in 3-stages: colectomy ​+ ​ileostomy, proctectomy ​+ ​pouch creation with diverting loop ileostomy, then subsequent ileostomy closure. Modified 2-stage IPAA is without pouch diversion, thus avoiding a third operation. This study compares perioperative complications, quality of life (QOL) and functional outcomes of 3- versus modified 2-stage IPAA.

METHODS

Charts were reviewed for adult UC patients undergoing IPAA between 2010 and 2020. QOL and function were assessed with EQ-5D-3L Quality of Life and Pouch Functional Score questionnaires.

RESULTS

152 patients were identified. 43 modified 2-stage and 109 3-stage IPAA were similar for anastomotic leak (9.3% vs. 1.8%, p ​= ​0.06), SSI (34.9% vs. 29.7%, p ​= ​0.51) and ileus (32.6% vs. 33%, p ​= ​0.96). Modified 2-stage had less bowel obstruction than 3-stage IPAA (7.0% vs. 30.1%, p ​= ​0.006). 92 patients returned questionnaires with similar QOL and pouch function.

CONCLUSIONS

Perioperative complications, QOL and function are similar for 3-stage IPAA and modified 2-stage IPAA. Modified 2-stage IPAA in select patients is safe and has less postoperative bowel obstruction than 3-stage IPAA.

An efficient 3D adsorbent foam based on graphene oxide/AgO nanoparticles for rapid vortex-assisted floating solid phase extraction of bisphenol A in canned food products

In this study, a three-dimensional adsorbent was developed based on graphene oxide/AgO nanoparticles over interconnected nickel foam (GO/AgO@Ni foam) for rapid and efficient vortex assisted floating solid phase extraction of bisphenol A in canned food products prior to high performance liquid chromatography with a fluorescence detector. The analytical techniques scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDX) and Fourier transform infrared (FT-IR) were used for characterization of the synthetized GO/AgO@Ni foam. The effect of proficiency factors including pH, foam size, vortexing time, salt addition, sample volume, desorption type and volume, and desorption time on the extraction efficiency of bisphenol A were explored through the matrix match method. Under the above experimental conditions, the figures of merit of the method were acquired as LODs (S/N = 3) of 0.18-0.84 μg kg^-1, LOQs of 0.61-2.81 μg kg^-1 (S/N = 10), linear ranges of 0.5-500 μg kg^-1, and enrichment factors of 235.5-244.9. The inter-day precision values (RSD%, n = 7) of 2.5-3.6 and the intra-day precision (%) of (5 days and seven replicates for each day) 2.8-3.8 were achieved for bisphenol A at a concentration of 50 μg kg^-1. The relative recoveries of 94.0% to 99.6% were obtained for the canned food samples.