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  • Title: Ileal-pouch-anal anastomosis after restorative proctocolectomy in patients with ulcerative colitis or familial adenomatous polyposis.
    Author: Bednarz W, Olewinski R, Wojczys R, Sutkowski K, Domoslawski P, Balcerzak W.
    Journal: Hepatogastroenterology; 2005; 52(64):1101-5. PubMed ID: 16001639.
    Abstract:
    BACKGROUND/AIMS: Restorative proctocolectomy is the "golden standard" in surgical treatment of ulcerative colitis and familial adenomatous polyposis. The two alternative techniques of ileal-pouch-anal anastomosis include hand-made suture and double line stapled suture. The aim of the study was the analysis of postoperative complications and functional results of the two types of anastomosis. METHODOLOGY: Analyzed group consisted of 71 patients operated between 1994 and 2003 for ulcerative colitis (n=62) or familial adenomatous polyposis (n=9). Stapled anastomosis was performed in 56 (79%) cases whereas hand-made suture was performed in 15 (21%) cases. RESULTS: No significant differences between the two anastomosis techniques were found in terms of postoperative complications as well as late functional results. CONCLUSIONS: The low rate of complications and well accepted functional outcome prove that restorative proctocolectomy is a safe surgical procedure which may be offered to patients with ulcerative colitis of familial adenomatous polyposis. Double line stapled suture should be the preferred method of ileal-pouch-anal anastomosis, however hand-made suture remains its valuable alternative and may be considered in selected cases.
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