Ileal-pouch-anal anastomosis after restorative proctocolectomy in patients with ulcerative colitis or familial adenomatous polyposis

Abstract

Background/aims: 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.

Methodology: 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.