Early Postoperative Complications After Stapled vs Handsewn Restorative Proctocolectomy with Ileal Pouch-Anal Anastomosis in 148 Patients with Familial Adenomatous Polyposis Coli: A Matched-Pair Analysis | oneFAPvoice

welcome to oneFAPvoice

- a positively charged Familial Adenomatous Polyposis community.
  • join today!
scientific articles

Early Postoperative Complications After Stapled vs Handsewn Restorative Proctocolectomy with Ileal Pouch-Anal Anastomosis in 148 Patients with Familial Adenomatous Polyposis Coli: A Matched-Pair Analysis

key information

source: Colorectal disease

year: 2014

authors: Ganschow P, Warth R, Hinz U, Büchler M W, Kadmon M

summary/abstract:

AIM : Restorative proctocolectomy with ileal pouch-anal anastomosis for patients with familial adenomatous polyposis (FAP) and ulcerative colitis (UC) has been modified from a transanal hand-suture after mucosectomy to a stapled ileal pouch-anal anastomosis (IPAA) without mucosectomy. Better functional results favour stapled anastomosis; however, stapled anastomosis results in higher rates of adenomas in persisting anorectal mucosa. The purpose of this study was to compare the two techniques of pouch-anal anastomosis with respect to early postoperative complications in a collective of FAP patients.

METHOD : The study was performed as a matched-pair analysis. Data were obtained from a prospectively collected database.

RESULTS : The overall rate of postoperative complications was higher after stapled IPAA (31% stapled vs 23% handsewn), with anastomotic stricture occurring in 24.3% (stapled) and 16.2% (handsewn) (P = 0.22). Any leakage or pelvic abscess formation after stapled anastomosis occurred within 30 days in almost all patients, whereas these were mainly diagnosed between 30 days and 6 months after handsewn IPAA. A laparoscopic approach was used in 56.7% of patients in the stapled group but in only two patients in the handsewn group. Intra-operative blood loss was significantly higher in the handsewn group (mean ± SD: 699 ± 511 ml vs 369 ± 343 ml; P < 0.0001), as was the volume of blood transfused (mean ± SD: 205 ± 365 ml vs 8 ± 49 ml; P < 0.0001). Function did not differ between the groups.

CONCLUSION : There was a nonstatistically significant tendency towards a higher rate of early postoperative complications after stapled IPAA. The timing of anastomotic leakage and abscess formation differed between the groups.

organization: University of Heidelberg

DOI: 10.1111/codi.12385

read more full text source

expertly curated content related to this topic

The cookie settings on this website are set to "allow cookies" to give you the best browsing experience possible. If you continue to use this website without changing your cookie settings or you click "Accept" below then you are consenting to this.

Close