Anal transition zone in the surgical management of ulcerative colitis.
Preservation of the anal transition zone has long been a significant source of controversy in the surgical management of ulcerative colitis. The two techniques for restorative proctocolectomy and ileal pouch anal anastomosis (RPC IPAA) in common practice are a stapled anastomosis and a handsewn anastomosis; these techniques differ in the amount of remaining rectal mucosa and therefore the presence of the anal transition zone following surgery. Each technique has advantages and disadvantages in long-term functional outcomes, operative and postoperative complications, and risk of neoplasia. Therefore, we propose a selective approach to performing a stapled RPC IPAA based on the presence of dysplasia in the preoperative endoscopic evaluation.
Holder-Murray
Jennifer
J
Fichera
Alessandro
A
D000230:Adenocarcinoma / Q000601:surgery; D001003:Anal Canal / Q000033:anatomy & histology* / Q000601:surgery*; D000714:Anastomosis, Surgical / Q000379:methods; D003093:Colitis, Ulcerative / Q000601:surgery*; D039021:Colonic Pouches; D006801:Humans; D007249:Inflammation; D011183:Postoperative Complications / Q000517:prevention & control; D016737:Proctocolectomy, Restorative / Q000379:methods*; D012004:Rectal Neoplasms / Q000601:surgery; D018805:Sepsis / Q000517:prevention & control; D013537:Sutures; D016896:Treatment Outcome