Function after ileal pouch and stapled pouch-anal anastomosis for ulcerative colitis.
Fourteen patients with ulcerative colitis underwent formation of an S ileal pouch and construction of a stapled pouch-anal anastomosis by a modified technique, which eliminated the use of purse-string sutures. Eleven have had their covering ileostomies closed. Anal manometry performed before and a median of 9 months after ileostomy closure showed significant impairment of internal anal sphincter function. Night evacuation was significantly reduced in the stapled group compared with a similar group of patients who had undergone S ileal pouch formation, mucosal proctectomy and manual transanal anastomosis, but this was the only parameter of function to show a difference. A stapled pouch-anal anastomosis may be superior to the conventional procedure but it still may lead to internal anal sphincter damage which cannot be due to mucosectomy or prolonged anal retraction.
Williams
N S
NS
Surgical Unit, London Hospital, Whitechapel, UK.
Marzouk
D E
DE
Hallan
R I
RI
Waldron
D J
DJ
D000293:Adolescent; D000328:Adult; D001003:Anal Canal / Q000503:physiopathology / Q000601:surgery*; D003093:Colitis, Ulcerative / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery*; D008297:Male; D008722:Methods; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011312:Pressure; D012007:Rectum / Q000601:surgery; D013528:Surgical Staplers