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Outcome after ileal pouch‐anal anastomosis in ulcerative colitis patients: experience during a 27‐year period
Author(s) -
Tonelli Francesco,
Giudici Francesco,
Di Martino Carmela,
Scaringi Stefano,
Ficari Ferdinando,
Addasi Rami
Publication year - 2016
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.13699
Subject(s) - medicine , ulcerative colitis , anastomosis , pouch , proctocolectomy , surgery , gastroenterology , general surgery , disease
Background No previous study describes the postoperative outcome and functional results after ileal pouch‐anal anastomosis ( IPAA ), performed in ulcerative colitis by the same surgical team with the different anastomotic techniques adopted in a 27‐year period. Methods Prospectively, consecutive 333 ulcerative colitis patients operated adopting different IPAA techniques during the open surgery period 1984–2011 were enrolled. IPAA was performed using single stapling ( SS ) technique in 38 patients, double stapling ( DS ) technique in 235 patients ( TIA stapler 42 patients, Endo‐ GIA 131 patients, Contour 62 patients) and handsewn IPAA in 60 patients. Results Statistically different early and late complications were recorded among the different IPAA techniques. A lower frequency of daily and nocturnal defecations and a higher level of continence were observed in the DS‐IPAA compared to handsewn IPAA . The distance between the anastomotic line and the anal verge was significantly lower in DS Endo‐ GIA or DS Contour groups than in the DS TIA and SS . In SS IPAA group, 31.6% developed cuffitis compared to 14.4% belonging to DS group, at a mean follow‐up of 140.4 months. Conclusions Technical improvements changed the IPAA technique. Stapled IPAA is characterized by better functional outcome than handsewn IPAA . DS Endo‐ GIA and Contour IPAA are followed by lower risk of cuffitis.