The Stapled Deal Pouch-Anal Anastomosis a Randomized Study Comparing two Different Pouch Designs

Abstract

Thirty patients were operated on with restorative proctocolectomy with an end-to-end ileal pouch-anal anastomosis constructed by double stapling (STP). Pouches were randomized to either J type or K. type (folded by the principles used for the Kock continent ileostomy). Manovolumetric and functional results were compared. Patients were followed up for at least 6 months. K pouches acquired a significantly larger volume than the J-configurated pouches, and at 6 months the mean ± SD volumes amounted to 361 ±59.8 ml versus 283 ±43.0 ml (p<0.01) with a concomitant reduction in 24-h frequency (4.4 ± 1.5 versus 5.8 ± 1.9; p < 0.05). The initial postoperative mean reduction of resting anal pressure amounted to 33%, which was similar to that observed in a group of matched historical controls operated on with endoanal mucosectomy and hand-sutured pouch-anal anastomosis. Compared with these controls STP patients showed a superior overall functional result, most marked in the early postoperative period.

Key Words:

• Anastomosis
• manovolumetry
• pelvic ileal pouch
• stapling
• ulcerative colitis