Ileoanal anastomosis for ulcerative colitis: Results of an evolutionary surgical procedure

BACKGROUND/AIMS: Proctocolectomy with ileoanal anastomosis (IAA) has proved to be the most suitable surgical treatment for ulcerative colitis. The aim of this study was to compare the results of IAA according to the evolution of surgical procedures and particularly to compare the results of stapled versus hand-sewn anastomosis. METHODOLOGY: From 1984 to 1996, 37 men and 31 women were operated on in our centre for ulcerative colitis. The anastomosis between the J pouch and the dentate line was handsewn in 35 patients (group 1) and stapled in 33 patie nts (group 2). RESULTS: The mean operative time was significantly shorter in group 2 as co mpared with group 1 (265+/-59 vs. 323+/-53, p<0,01, respectively), whereas morbidity and functional results were comparable in both groups. In 10 pati ents with stapled IAA, a diverting ileostomy was not performed and the morb idity in this group did not increase. CONCLUSIONS: These results suggest that stapled IAA anastomosis is a safe p rocedure. The stapling technique of IAA simplifies total excision of the re ctum and could mean that a diverting ileostomy is not necessary.