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  • Title: Manometric and functional comparison of ileal pouch anal anastomosis with and without anal manipulation.
    Author: Tuckson W, Lavery I, Fazio V, Oakley J, Church J, Milsom J.
    Journal: Am J Surg; 1991 Jan; 161(1):90-5; discussion 95-6. PubMed ID: 1987862.
    Abstract:
    We report the results of postoperative physiologic and functional evaluation of 153 patients with ileal pouch anal-anastomosis (IPAA). Ninety-nine patients had anal manipulation for either mucosal proctectomy, transanal placement pursestring suture with stapled IPAA, or handsewn IPAA (manipulation). Fifty-four patients had stapled IPAA with anal pursestrings placed transabdominally without mucosectomy (no manipulation). Patients with transabdominal anal pursestring placement and stapled IPAA without mucosectomy had a higher mean maximum anal resting pressure than patients who had endoanal manipulation. This correlates with improved continence and a reduced need to wear a pad. Avoidance of anal manipulation preserves anal canal resting tone and improves the functional result after IPAA.
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