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April 1993

Stapled vs Hand-Sutured lleoanal Anastomosis in Restorative Proctocolectomy: A Prospective, Randomized Study

Author Affiliations

From the Department of Surgery, University Central Hospital, Helsinki, Finland.

Arch Surg. 1993;128(4):437-440. doi:10.1001/archsurg.1993.01420160075012

• A prospective, randomized study of hand-sutured (group 1, n=19) and double-stapled (group 2, n=21) ileoanal anastomosis was carried out in 40 consecutive patients during restorative proctocolectomy to compare complications and functional outcome. Eight patients (42%) in group 1 and 12 (57%) in group 2 had one or more complications. Four patients in group 1 and five in group 2 developed pelvic sepsis. One stapled anastomosis had to be converted to a hand-sutured one because of severe anastomotic stricture. Four patients in group 1 and eight in group 2 had no nighttime evacuations 3 months after surgery and seven patients in group 1 and 11 in group 2 had no nighttime evacuations six months after surgery. Mucous leakage occurred in two vs five patients after 6 months in groups 1 and 2, respectively. The mean resting anal pressure decreased 30% in group 1 and 28% in group 2. In conclusion, double-stapled ileoanal anastomosis does not offer any functional or technical advantage over hand-sutured anastomosis, but it does leave some of the disease behind.

(Arch Surg. 1993;128:437-440)

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