Ileal-pouch-anal anastomosis after restorative proctocolectomy in patients with ulcerative colitis or familial adenomatous polyposis.
OBJECTIVE
Restorative proctocolectomy is the "golden standard" in surgical treatment of ulcerative colitis and familial adenomatous polyposis. The two alternative techniques of ileal-pouch-anal anastomosis include hand-made suture and double line stapled suture. The aim of the study was the analysis of postoperative complications and functional results of the two types of anastomosis.


METHODS
Analyzed group consisted of 71 patients operated between 1994 and 2003 for ulcerative colitis (n=62) or familial adenomatous polyposis (n=9). Stapled anastomosis was performed in 56 (79%) cases whereas hand-made suture was performed in 15 (21%) cases.


RESULTS
No significant differences between the two anastomosis techniques were found in terms of postoperative complications as well as late functional results.


CONCLUSIONS
The low rate of complications and well accepted functional outcome prove that restorative proctocolectomy is a safe surgical procedure which may be offered to patients with ulcerative colitis of familial adenomatous polyposis. Double line stapled suture should be the preferred method of ileal-pouch-anal anastomosis, however hand-made suture remains its valuable alternative and may be considered in selected cases.
Department of General, Gastroenterologic and Endocrine Surgery, Medical University in Wroclaw, Poland. wbednarz@op.pl
Wiktor
W
Bednarz
Robert
R
Olewinski
Romualda
R
Wojczys
Krzysztof
K
Sutkowski
Pawel
P
Domoslawski
Waldemar
W
Balcerzak
D011125:Adenomatous Polyposis Coli / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D003093:Colitis, Ulcerative / Q000601:surgery*; D039021:Colonic Pouches; D003672:Defecation / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016737:Proctocolectomy, Restorative / Q000009:adverse effects / Q000379:methods*; D013536:Suture Techniques; D016896:Treatment Outcome