title: Complications after J-pouch ileoanal anastomosis: stapled compared with handsewn anastomosis.
abstract: OBJECTIVE
  To compare the morbidity after stapled compared with handsewn J-pouch ileoanal anastomoses.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  University Hospital, Copenhagen, Denmark.
  
  
  METHODS
  144 consecutive patients who underwent either handsewn or stapled J-pouch ileoanal anastomosis between November 1983 and December 1991.
  
  
  METHODS
  Length of operation; operative blood loss; incidence of anastomotic breakdown, fistula and stenosis; and number of pouches that were excised as a result of complications.
  
  
  RESULTS
  Ninety-six patients had handsewn, and 48 patients had stapled, anastomoses. There were no differences between the groups except in the length of operation (median (range) 270 (155-420) in the handsewn group compared with 197 (135-300) in the stapled group, p < 0.001), and the incidence of later stenosis of the anastomosis (22/96, 23%, compared with 3/48, 6%, p = 0.02). Patients who developed anastomotic breakdown lost significantly more blood during operation (median 2300 ml, range 1100-7500, compared with 1600 ml, range 600-6000, p = 0.02), and women were more likely to develop anastomotic leaks than men (15/70 compared with 3/74, p = 0.009).
  
  
  CONCLUSIONS
  We conclude that so far the stapled anastomoses have given superior results, but it remains to be seen whether other differences will emerge as length of follow up increases.
authors.affiliation: Department of Gastrointestinal Surgery C, Rigshospitalet, University of Copenhagen, Denmark.
authors.forename: A
authors.initials: A
authors.lastname: Wettergren
authors.forename: H J
authors.initials: HJ
authors.lastname: Gyrtrup
authors.forename: E
authors.initials: E
authors.lastname: Grosmann
authors.forename: L B
authors.initials: LB
authors.lastname: Svendsen
authors.forename: A
authors.initials: A
authors.lastname: Hjortrup
authors.forename: F
authors.initials: F
authors.lastname: Stadil
authors.forename: P
authors.initials: P
authors.lastname: Kirkegaard
mesh_terms: D000293:Adolescent; D000328:Adult; D016063:Blood Loss, Surgical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D016737:Proctocolectomy, Restorative / Q000009:adverse effects* / Q000379:methods; D012086:Reoperation; D012189:Retrospective Studies; D012737:Sex Factors; D013528:Surgical Staplers; D013529:Surgical Wound Dehiscence / Q000453:epidemiology / Q000209:etiology