Stapled functional end-to-end anastomosis versus sutured end-to-end anastomosis after ileocolonic resection in Crohn disease

Scand J Gastroenterol. 1999 Jul;34(7):708-13. doi: 10.1080/003655299750025921.


Background: The aim of this retrospective study was to compare complications and anastomotic recurrence rates after stapled functional end-to-end versus conventional sutured end-to-end anastomosis after ileocolonic resection in Crohn disease.

Methods: Between 1988 and 1997, 123 patients underwent ileocolonic resection for Crohn disease. Forty-five patients underwent stapled functional end-to-end anastomosis (stapled group), and 78 underwent sutured end-to-end anastomosis (sutured group).

Results: The stapled anastomosis has been more frequently used during the past 3 years; between 1995 and 1997 it was used in 33 (83%) of 40 patients, compared with only 12 (14%) of 83 patients between 1988 and 1994. There was one anastomotic leak (2%) in the stapled group, compared with six (8%) in the sutured group. The overall complication rate was significantly lower in the stapled group (7% versus 23%, P = 0.04). In the stapled group only one patient required reoperation for ileocolonic anastomotic recurrence, compared with 26 in the sutured group. The cumulative 1-, 2- and 5-year rates for ileocolonic recurrences requiring surgery in the stapled group were 0%, 0%, and 3%, which were significantly lower than the 5%, 11%, and 24% in the sutured group (P = 0.007 by log-rank test).

Conclusions: Although the follow-up duration was short in the stapled group, these results suggest that stapled functional end-to-end ileocolonic anastomosis is associated with a lower incidence of complications and that early anastomotic recurrence is less common than after sutured end-to-end anastomosis. However, a randomized trial would be necessary to draw clear conclusions.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anastomosis, Surgical / methods*
  • Crohn Disease / surgery*
  • Female
  • Humans
  • Ileum / surgery
  • Length of Stay
  • Male
  • Middle Aged
  • Postoperative Complications
  • Reoperation
  • Retrospective Studies
  • Statistics, Nonparametric
  • Sutures*
  • Treatment Failure