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Randomised trial to determine the optimum level of pouch-anal anastomosis in stapled restoractive proctocolectomy

Show simple item record Deen, K.I. en_US Williams, J.G. en_US Grant, E.A. en_US Billingham, C. en_US Keighley, M.R.B. en_US 2014-10-29T09:14:30Z 2014-10-29T09:14:30Z 1995 en_US
dc.identifier.citation Disease of the Colon and Rectum. 1995; 38(2): pp.133-138 en_US
dc.identifier.issn 0012-3706 (Print) en_US
dc.identifier.issn 1530-0358 (Electronic) en_US
dc.description Indexed in MEDLINE
dc.description.abstract PURPOSE:This study was undertaken to identify the optimum level of stapled ileal pouch-anal anastomosis. METHOD: A prospective, randomized trial was completed to compare double-stapled ileoanal anastomosis placed at the top of anal columns (high, n = 26) with anastomosis at the dentate line (low, n = 21). RESULTS: There was no significant difference in the overall complication rate between operations (high, n = 7, vs. low, n = 8; P < 0.21). Pouch-anal functional score (scale 0-12; 0 = excellent, 12 = poor) was significantly better in the high anastomosis group (median (range): 2 (1-9) vs. 5.5 (1-12); P < 0.05). Incontinence occurred in only two patients randomized to high anastomosis compared with six in the low anastomosis group. Nocturnal soiling was reported in three patients after high anastomosis and in six patients after dentate line anastomosis. Both operations caused a significant but comparable reduction of maximum and resting pressure (31 percent after high anastomosis (P < 0.05); 23 percent after low anastomosis (P < 0.05)). However, a significant fall in functional length of the anal canal was only seen after a low pouch-anal anastomosis (P < 0.05). CONCLUSION: Stapled pouch-anal anastomosis at the top of anal columns gives better functional results compared with a stapled anastomosis at the dentate line.
dc.publisher Lippincott Williams and Wilkins en_US
dc.subject Clinical Trial
dc.subject Randomized Controlled Trial
dc.subject Anal Canal-surgery
dc.subject Anastomosis, Surgical-adverse effects
dc.subject Colitis, Ulcerative-surgery
dc.subject Ileostomy
dc.subject Ileum-surgery
dc.subject Proctocolectomy, Restorative-methods
dc.title Randomised trial to determine the optimum level of pouch-anal anastomosis in stapled restoractive proctocolectomy en_US
dc.type Article en_US
dc.identifier.department Surgery en_US
dc.creator.corporateauthor American Proctologic Society en_US
dc.creator.corporateauthor American Society of Colon and Rectal Surgeons en_US

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