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Double-stapledvs. handsewn ileal pouch-anal anastomosis in patients with chronic ulcerative colitis

  • Original Contributions
  • Published:
Diseases of the Colon & Rectum

Abstract

Proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the treatment of choice for most patients with chronic ulcerative colitis. Whether or not a double-stapled technique, which should preserve the anal transition zone and avoid prolonged anal dilation, facilitates superior fecal continence compared with conventional mucosal resection and handsewn anastomosis is unknown. PURPOSE: The aim of this study was to compare functional results after double-stapled and handsewn IPAA. METHODS: Twenty-seven consecutive patients (13 females, 14 males; mean age, 37 years) who had proctocolectomy and double-stapled IPAA (J) for chronic ulcerative colitis were identified. Each was matched by sex, age, and surgeon to a control who had undergone a conventional handsewn anastomosis. Functional results at six months after ileostomy closure were compared. RESULTS: Median stool frequency in each group was seven. The prevalence of pouchitis was 22 percent in both groups. One pouch failure occurred in each group. The percentage of patients from the double-stapled group with daytime spotting was similar to that of the handsewn group (18 percent vs. 26 percent,P>0.5). Nighttime soiling rates were similar as well (41 percent vs.48 percent,P>0.5). CONCLUSIONS: Double-stapled IPAA appears to convey no early functional advantage over handsewn IPAA for chronic ulcerative colitis.

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Author notes

  1. Robert W. Beart Jr. M.D.

    Present address: Department of Surgery, University of Southern California, 1510 San Pablo Street, #514, 90033-4612, Los Angeles, CA

Authors and Affiliations

  1. Division of Colon and Rectal Surgery, Mayo Clinic and Mayo Foundation, Rochester, Minnesota

    P. Bernard McIntyre M.D., John H. Pemberton M.D.,  Robert W. Beart Jr. M.D., Richard M. Devine M.D. & Santhat Nivatvongs M.D.

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  1. P. Bernard McIntyre M.D.
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  2. John H. Pemberton M.D.
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McIntyre, P.B., Pemberton, J.H., Beart, R.W. et al. Double-stapledvs. handsewn ileal pouch-anal anastomosis in patients with chronic ulcerative colitis. Dis Colon Rectum 37, 430–433 (1994). https://doi.org/10.1007/BF02076186

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