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Total proctocolectomy with ileal pouch-anal anastomosis by stapling technique
M T Jalal1, S H Sheikh, M S Hossain
1Bangabandhu Sheikh Mujib Medical University, Shahbagh, Dhaka, Bangladesh.
Mymensingh Medical Journal : MMJ
|November 9, 2012
Summary
Ileal pouch-anal anastomosis (IPAA) using stapling techniques offers a viable alternative to permanent ileostomy for ulcerative colitis and familial adenomatous polyposis. This study found all patients achieved continence and excellent outcomes without mucosectomy.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Colorectal Surgery
Background:
- Ileal pouch-anal anastomosis (IPAA) is the gold standard for ulcerative colitis and familial adenomatous polyposis.
- J-pouch construction is a common method for creating the ileal reservoir.
Purpose of the Study:
- To evaluate the outcomes of IPAA performed using a stapling technique after total proctocolectomy.
- To assess the efficacy and safety of this technique, particularly without mucosectomy.
Main Methods:
- Prospective observational study involving six patients undergoing total proctocolectomy and IPAA.
- Utilized a GIA device for J-pouch creation and staplers for the pouch-anal anastomosis.
Main Results:
- All six patients achieved fecal continence.
- Excellent disease-specific outcomes were observed in patients with familial adenomatous polyposis and ulcerative colitis.
- The stapling technique without mucosectomy proved effective.
Conclusions:
- IPAA using stapling devices is a feasible and effective alternative to permanent ileostomy.
- The procedure demonstrates satisfactory results and continence, even without mucosectomy.
- This technique offers a viable surgical option for patients requiring proctocolectomy.
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