Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 25 November 2017

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Hand-sewn vs stapled pouch-anal anastomosis

Both techniques have similar early postoperative outcomes, although stapled ileal pouch-anal anastomosis improves nocturnal continence, report researchers in the most recent issue of Annals of Surgery.

News image

fiogf49gjkf04

The choice of mucosectomy and hand-sewn versus stapled ileal pouch-anal anastomosis has been a subject of debate.

There is no clear consensus as to which method provides better functional results and long-term outcomes.

Dr Richard Lovegrove and colleagues compared outcomes of stapled versus hand-sewn pouch-anal anastomosis after restorative proctocolectomy.

The research team used meta-analytical techniques.

Studies published between 1988 and 2003 of hand-sewn versus stapled ileal pouch-anal anastomosis were included.

Endpoints included functional and physiologic outcomes at least 3 months following closure of ileostomy or surgery if no proximal diversion was used.

Quality of life following surgery, and neoplastic transformation within the anal transition zone were also measured.The researchers identified 21 studies, consisting of 4183 patients.

The incidence of pad usage favored stapled pouch-anal anastomosis
Annals of Surgery

Of the identified patients, 2699 underwent hand-sewn techniques and 1484 received stapled ileal pouch-anal anastomosis.

The team found no significant difference in the incidence of postoperative complications between the 2 groups.

The incidence of nocturnal seepage and pad usage favored the stapled ileal pouch-anal anastomosis.

The team noted that the frequency of defecation was not significantly different between the 2 groups, nor was the use of antidiarrheal medication.

Anorectal physiologic measurements showed a reduction in the resting and squeeze pressure in the hand-sewn ileal pouch-anal anastomosis group by 13 and 14 mm Hg, respectively.

The stapled ileal pouch-anal anastomosis group showed a higher incidence of dysplasia in the anal transition zone that did not reach statistical significance.

Dr Lovegrove's team concluded, “Both techniques had similar early postoperative outcomes.”

“Stapled ileal pouch-anal anastomosis offered improved nocturnal continence, which was reflected in higher anorectal physiologic measurements.”

“A risk of increased incidence of dysplasia in the anal transition zone may exist in the stapled group that cannot be quantified by this study.”

“They describe a decision algorithm for the choice of ileal pouch-anal anastomosis, based on the relative risk of long-term neoplastic transformation.”

Ann Surg 2006: 244(1): 18-26
26 June 2006

Go to top of page Email this page Email this page to a colleague

 24 November 2017 
Osteoporotic fractures in Barrett's esophagus
 24 November 2017 
Center ERCP volume and procedure success
 24 November 2017 
Adipokines and IBD
 23 November 2017 
Pharmacological management of GERD
 23 November 2017 
Incidence of biopsy-verified celiac disease
 23 November 2017 
Distance travelling for rectal cancer outcomes
 22 November 2017 
Challenges of US-trained gastroenterologists when abroad
 22 November 2017 
Surgical treatment delays influence survival in colon cancer
 22 November 2017 
Golimumab in Crohn's disease
 21 November 2017 
Preoperative optimization in IBD patients
 21 November 2017 
Cholangiopathy in critically ill patients
 21 November 2017 
Prepregnancy obesity and maternal mortality
 20 November 2017 
Barriers to hepatitis C treatment
 20 November 2017 
Socioeconomic characteristics in diverticular disease
 20 November 2017 
Endoscopic indices of disease activity for Crohn’s
 17 November 2017 
Food elimination diets for treatment of adults with eosinophilic esophagitis
 17 November 2017 
PPI use and cognitive function in women
 17 November 2017 
Predicting microscopic colitis
 16 November 2017 
NAFLD-hepatocellular carcinoma and survival after orthotopic liver transplant
 16 November 2017 
Prepregnancy obesity and severe maternal morbidity
 16 November 2017 
Celiac disease screening in adult first-degree relatives
 15 November 2017 
Breastfeeding and the risk of IBD
 15 November 2017 
Predicting recurrence after curative rectal cancer surgery
 15 November 2017 
Medication nonadherence and health care costs
 14 November 2017 
Eosinophilic gastroenteritis and colitis
 14 November 2017 
HBV/HCV coinfection and cirrhosis
 14 November 2017 
Sexual dysfunction after rectal cancer surgery
 13 November 2017 
Genetic polymorphisms, fatty acids and ulcerative colitis
 13 November 2017 
Flares after immunomodulator withdrawal in Crohn's
 13 November 2017 
GI bleeding in patients taking non–vitamin K antagonist oral anticoagulants
 10 November 2017 
Thiopurines vs TNF and lymphoma risk in IBD
 10 November 2017 
Drug monitoring of anti-tumour necrosis factor therapy in IBD
 10 November 2017 
Treatment decisions for older patients with colorectal cancer
 09 November 2017 
Quality standards in upper gastrointestinal endoscopy
 09 November 2017 
Irradiated rectal cancer and chemoradiotherapy
 09 November 2017 
Environmental factors and IBD
 08 November 2017 
Prophylaxis of spontaneous bacterial peritonitis
 08 November 2017 
Optimal management of postoperative Crohn's disease
 07 November 2017 
Community Screening for Helicobacter pylori
 07 November 2017 
Early readmission in IBD patients
 07 November 2017 
Mesocolic excision for colon cancer
 06 November 2017 
Food elimination diet for children with eosinophilic esophagitis
 06 November 2017 
Biologic agents and obesity in children with IBD
 06 November 2017 
Liver cancer burden despite extensive use of antiviral agents
 03 November 2017 
Statins and mortality in chronic viral hepatitis
 03 November 2017 
Propofol for outpatient colonoscopy
 03 November 2017 
Asthma and IBD development
 02 November 2017 
Diverticulitis and emergency department burden
 02 November 2017 
Rural residence and risk of IBD
 02 November 2017 
Sexual functioning in Hep C
 01 November 2017 
Autoimmune pancreatitis in children
 01 November 2017 
Heartburn relief in adolescents with GERD
 31 October 2017 
Follow-up of positive results on fecal blood tests
 31 October 2017 
Surveillance in ulcerative colitis and Crohn’s disease
 30 October 2017 
Local recurrence after curative rectal cancer surgery
 30 October 2017 
Low-flow ascites pump in refractory cirrhosis
 30 October 2017 
Medical therapy of patients with pediatric-onset IBD
 27 October 2017 
NAFLD in advanced fibrosis in the USA
 27 October 2017 
Early readmission in cirrhosis after bacterial infections
 26 October 2017 
Predicting response to anti-TNF therapy in Crohn's

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2017 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us