Elimination of mucosectomy during restorative proctocolectomy in patients with ulcerative colitis may provide better results in low-volume centers.
BACKGROUND
To compare the outcomes of hand-sewn and double-stapling techniques among ulcerative colitis patients undergoing restorative proctocolectomy at a center that has limited experience with restorative proctocolectomy.


METHODS
Forty-four patients with ulcerative colitis were divided into two groups according to the anastomosis techniques: hand sewing and double stapling. Postoperative early and late complications, postoperative hospital stay, and long-term functional results were compared.


RESULTS
Pelvic sepsis (9% versus 36%, P = 0.03), operation time (median 240 minutes versus 270 minutes, P = 0.01), postoperative hospital stay (median 9 days versus 12 days, P = 0.04), and night incontinence (42% versus 80%, P = 0.07) were less common in the double-stapling group.


CONCLUSIONS
We recommend the double-stapling technique to centers that do not have extensive experience with restorative proctocolectomy for ulcerative colitis. This technique provides a good postoperative course in most patients and provides satisfactory long-term results. The results of the double-stapling group were similar to the results of the high-volume centers.
Kayaalp
Cuneyt
C
Turkey Yuksek Ihtisas Hospital, Department of Gastrointestinal Surgery, Ankara, Turkey. cuneytkayaalp@hotmail.com
Nessar
Gurel
G
Akoglu
Musa
M
Atalay
Fuat
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D003093:Colitis, Ulcerative / Q000601:surgery*; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000601:surgery; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016737:Proctocolectomy, Restorative / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D017792:Surgical Stapling; D013537:Sutures; D016896:Treatment Outcome