Document Detail


Influence of stapler size used at ileal pouch-anal anastomosis on anastomotic leak, stricture, long-term functional outcomes, and quality of life.
MedLine Citation:
PMID:  20637338     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The aim of this study was to evaluate whether stapler size used at ileal pouch-anal anastomosis (IPAA) influences outcomes. METHODS: Data of patients undergoing stapled IPAA (1983-2007) were obtained. Differences between groups A (stapler size 28-29 mm) and B (31-33 mm) for pre- and perioperative factors, stricture, leak, quality of life (QOL), and function were compared. Associations between stapler size and stricture or leak were assessed with a multivariable Cox model. RESULTS: Groups A (n = 1,221) and B (n = 899) had comparable age, diagnosis, body mass index (BMI), and albumin level. Group B had more males (P < .001) but fewer patients with ileostomy (P < .001). There was no significant difference in rates of leak (4.5% vs 6.2%, P = .08) or stricture (1.9% vs 2.7%, P = .1) for groups A and B. On multivariate analysis, female gender was associated with stricture, while greater BMI and male gender were associated with leak. Group A had greater urgency at 1 year and nighttime pad use at 15 years. The other determinants of function and QOL were similar. CONCLUSIONS: There was no significant association between the size of stapler used at IPAA and long-term complications.
Authors:
Hasan T Kirat; Ravi P Kiran; Lei Lian; Feza H Remzi; Victor W Fazio
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of surgery     Volume:  200     ISSN:  1879-1883     ISO Abbreviation:  Am. J. Surg.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-19     Completed Date:  2010-08-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370473     Medline TA:  Am J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  68-72     Citation Subset:  AIM; IM    
Copyright Information:
Copyright (c) 2010 Elsevier Inc. All rights reserved.
Affiliation:
Department of Colorectal Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA. kiranp@ccf.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Cohort Studies
Colonic Diseases / complications,  pathology,  surgery*
Colonic Pouches / adverse effects*
Constriction, Pathologic / epidemiology
Equipment Design
Female
Humans
Male
Middle Aged
Postoperative Complications*
Quality of Life*
Recovery of Function
Retrospective Studies
Surgical Staplers*
Surgical Stapling*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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