Ileal pouch anal function after endoanal mucosectomy and handsewn ileoanal anastomosis compared with stapled anastomosis without mucosectomy

Eur J Surg. 1995 Dec;161(12):915-21.


Objective: To compare manovolumetric results and functional outcome after restorative proctocolectomy with either mucosal proctectomy and handsewn pouch-anal anastomosis or stapling.

Design: Prospective randomised study.

Setting: University hospital, Sweden.

Subjects: 80 Consecutive patients undergoing restorative proctocolectomy.

Interventions: 37 patients were randomised to have mucosectomy and a handsewn anastomosis and 43 patients to have a stapled anastomosis.

Main outcome measures: Comparisons of anal sphincter function and clinical outcome in terms of continence and overall functional score between the two groups of patients.

Results: There was persistent reduction in anal resting tone at one year amounting to 29% in the handsewn group and and to 21% in the stapled group (p < 0.001 compared with preoperative in both groups). Daytime continence was similar, but patients with stapled anastomoses experienced less soiling during sleep, especially in the early postoperative period (5/43, 12% compared with 15/33, 45% at one month, p < 0.001). The arbitrary overall functional score was, however, similar in both groups.

Conclusion: Handsewn and stapled ileal pouch-anal anastomoses result in similar postoperative anal sphincter impairment and overall clinical outcome.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anal Canal / physiology
  • Anastomosis, Surgical / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications
  • Postoperative Period
  • Pressure
  • Proctocolectomy, Restorative / methods*
  • Prospective Studies
  • Surgical Stapling*
  • Treatment Outcome