Functional outcome in handsewn versus stapled ileal pouch-anal anastomosis

Giuseppe Gozzetti, Gilberto Poggioli, Floriano Marchetti, Silvio Laureti, Gian Luca Grazi, Mario Mastrorilli, Simonetta Selleri, Luca Stocchi, Massimo Di Simone

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Eighty-eight of 119 patients who underwent ileal pouch-anal anastomosis for ulcerative colitis were evaluated. Forty patients had a handsewn anastomosis (Hs) with mucosectomy, and 48 had a stapled anastomosis (St). In each patient, we evaluated operative, morphologic, functional, and manometric features. The results in the Hs and St groups were similar when the anastomosis was within 1 cm of the dentate line. In particular, there was no correlation between the type of anastomosis and the number of bowel movements in a 24-hour period, the presence of the urge to defecate, and the use of antidiarrheal drugs. Leakage was significantly higher in the Hs group, even when the anastomosis was less than 1 cm from the dentate line. Pouchitis was more frequent in the Hs group, and, within this group, among those with a short distance between the anastomosis and the dentate line. No correlations were found between the presence of columnar epithelium or active colitis in the mucosa below the anastomosis, the functional outcomes, and the incidence of pouchitis.

Original languageEnglish
Pages (from-to)325-329
Number of pages5
JournalAmerican Journal of Surgery
Issue number4
Publication statusPublished - 1994

ASJC Scopus subject areas

  • Surgery


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