A. Senapati et al., STENOSIS OF THE POUCH-ANAL ANASTOMOSIS FOLLOWING RESTORATIVE PROCTOCOLECTOMY, International journal of colorectal disease, 11(2), 1996, pp. 57-59
Purpose: To compare the incidence of stenosis after hand-sewn and stap
led ileoanal anastomosis. Stenosis of the ileoanal anastomosis occurs
in 5-16% of patients undergoing a restorative proctocolectomy but the
incidence using a stapled technique is unknown. Methods: Between 1976
and 1990, 266 patients underwent restorative proctocolectomy or procte
ctomy at one hospital. In two hundred and eighteen the anastomosis was
hand sewn and stapled in 48 (single 33; double 15). Results: Stenosis
occurred in 31 (14.2%) of the hand-sewn and in 19 (39.6%) of the stap
led anastomoses. This difference was highly significant (P < 0.001). S
tenosis was not related to the size of the staple head used or to the
stapling technique. There was no relationship between the development
of stenosis and pelvic sepsis. Twenty six (hand-sewn 16, stapled 10) o
f the 48 patients with stenosis needed dilatation under general anaest
hetic. Conclusion: Stapled anastomoses may result in a high incidence
of anastomotic stenosis.