FUNCTIONAL OUTCOME IN HANDSEWN VERSUS STAPLED ILEAL POUCH-ANAL ANASTOMOSIS

Eighty-eight of 119 patients who underwent ileal pouch-anal anastomosi s for ulcerative colitis were evaluated. Forty patients had a handsewn anastomosis (Hs) with mucosectomy, and 48 had a stapled anastomosis ( St). In each patient, we evaluated operative, morphologic, functional, and manometric features. The results in the Hs and St groups were sim ilar when the anastomosis was within 1 cm of the dentate line. In part icular, there was no correlation between the type of anastomosis and t he number of bowel movements in a 24-hour period, the presence of the urge to defecate, and the use of antidiarrheal drugs. Leakage was sign ificantly higher in the Hs group, even when the anastomosis was less t han 1 cm from the dentate line. Pouchitis was more frequent in the Hs group, and, within this group, among those with a short distance betwe en the anastomosis and the dentate line. No correlations were found be tween the presence of columnar epithelium or active colitis in the col umnar epithelium or active colitis in the mucosa below the anastomosis , the functional outcomes, and the incidence of pouchitis.