[Direct ileum pouch-anal anastomosis in ulcerative colitis: function and complications after stapler technique]

Stapled ileal pouch-anal anastomosis after proctocolectomy enables a continence preserving reconstruction. We assessed complications and functional outcome after ileoanal pouch-anastomosis in 86 consecutive patients with ulcerative colitis. There was no postoperative mortality. 2 patients required permanent ileostomy and pouch excision for manifestation of unsuspected Crohn's disease. Major postoperative complications consisted of pelvic sepsis (n = 2), anastomotic leakage (n = 4), bleeding (n = 1), pancreatitis (n = 3) and peritonitis (n = 1). Both frequencies of bowel movements and degree of continence improved with time. Two years after take down of the deviation ileostomy frequency of bowel movements was 5,6 [2]/die. At this time no patient complained of major incontinence. Minor incontinence was reported with 9% and 14% during day-time and night-time respectively. It is concluded that direct stapled ileal pouch-anal anastomosis is a safe procedure with excellent functional results for patients with ulcerative colitis.