Cuff-less J pouch anal stapling anastomosis for ulcerative colitis

Abstract

Background/Aim: For ulcerative colitis, J pouch anal anastomosis with preserved rectal cuff had been popularized with its acceptable defecation function. However, some complications associated with rectal cuff after surgery have been reported. We are performing a novel procedure, laparoscopic cuff-less J pouch anal stapling anastomosis. Patients and Methods: From January 2014 to December 2016, ten patients with ulcerative colitis, including three with concomitant cancer underwent this procedure. J pouch anal anastomosis was performed at the dentate line in all patients by our original procedure. In a manometric examination of all patients more than one year after the operation, maximum resting pressure was 68.0 (52-84) mmHg, maximum squeeze pressure was 101.7 (87-121) mmHg, length of high-pressure zone was 32.3 (30-35), and none had observed rectoanal reflex. Good defecation was confirmed by defecography. Conclusion: Cuff-less J pouch anal stapling anastomosis seems to be a useful procedure for patients with ulcerative colitis.