SynthesisAnnals of surgery2006
A comparison of hand-sewn versus stapled ileal pouch anal anastomosis (IPAA) following proctocolectomy: a meta-analysis of 4183 patients.
Synthesis in Annals of surgery, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 119 papers, 7 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
119 citing papers in PubMed, 7 syntheses or guidelines pooled it, 368 citations in OpenAlex.
- Preoperative anorectal manometry as a predictor of function after ileal pouch anal anastomosis: a systematic review and meta-analysis.Techniques in coloproctology · 2024Pooled it
- Transanal ileal pouch-anal anastomosis: A systematic review and meta-analysis of technical approaches and clinical outcomes.Langenbeck's archives of surgery · 2024Pooled it
- Hand suture versus stapler for closure of loop ileostomy--a systematic review and meta-analysis of randomized controlled trials.Langenbeck's archives of surgery · 2015Pooled it
- Preservation versus non-preservation of the duodenal passage following total gastrectomy: a systematic review.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2013Pooled it
- A systematic review of systematic reviews and panoramic meta-analysis: staples versus sutures for surgical procedures.PloS one · 2013Pooled it
- Update of complications and functional outcome of the ileo-pouch anal anastomosis: overview of evidence and meta-analysis of 96 observational studies.International journal of colorectal disease · 2012Pooled it
- Stapled versus handsewn methods for colorectal anastomosis surgery.The Cochrane database of systematic reviews · 2012Pooled it
- Comparison of standard 4-row versus 6-row3-D linear cutter stapler in creation of gastrointestinal system anastomoses: a prospective randomized trial.Clinics (Sao Paulo, Brazil) · 2012Trial
- Robotic ileal pouch-anal anastomosis after proctectomy: a feasible and promising approach? Short-term outcomes and long-term functional results from a two-center retrospective study.Journal of robotic surgery · 2026Article
- Single-stage laparoscopic proctocolectomy with ileal pouch-anal anastomosis for familial adenomatous polyposis.Pediatric surgery international · 2025Article
- Adenoma and carcinoma in the anal transitional zone following hand-sewn versus stapled ileal pouch-anal anastomosis in familial adenomatous polyposis.Familial cancer · 2025Article
- Visceral obesity as a predictor of ileal pouch reachability in ulcerative colitis: A prospective single-center study.International journal of colorectal disease · 2025Article
- Peristaltic contractility: another factor impacting IPAA function?International journal of colorectal disease · 2025Observational
- Pouch outcomes after minimally invasive vs. open proctectomy during IPAA reconstruction.Surgical endoscopy · 2025Article
- Medical, Endoscopic, and Surgical Treatments for Rectal Cuffitis in IBD Patients with an Ileal Pouch-Anal Anastomosis: A Narrative Review.Digestive diseases and sciences · 2025Review
- Extensive Disease and Exposure to Multiple Biologics Precolectomy Is Associated with Endoscopic Cuffitis Post-Ileal Pouch-Anal Anastomosis in Patients With Ulcerative Colitis.Inflammatory bowel diseases · 2025Article
- A review of early small bowel obstructions in staged IPAA procedures.Surgical endoscopy · 2025Article
- Ileal pouch-anal anastomosis for ulcerative colitis: 30-year analysis on surgical evolution and patient outcome.BJS open · 2024Article
- Efficacy of transanal drainage tube placement in preventing anastomotic leakage after ileal pouch-anal anastomosis in patients with ulcerative colitis.Surgical endoscopy · 2024Article
- Rectal Cancer and Radiation in Colitis.Clinics in colon and rectal surgery · 2024Review
59 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveUsing meta-analytical techniques, the study compared postoperative adverse events and functional outcomes of stapled versus hand-sewn ileal pouch-anal anastomosis (IPAA) following restorative proctocolectomy.
backgroundThe choice of mucosectomy and hand-sewn versus stapled pouch-anal anastomosis has been a subject of debate with no clear consensus as to which method provides better functional results and long-term outcomes.
methodsComparative studies published between 1988 and 2003, of hand-sewn versus stapled IPAA were included. Endpoints were classified into postoperative complications and functional and physiologic outcomes measured at least 3 months following closure of ileostomy or surgery if no proximal diversion was used, quality of life following surgery, and neoplastic transformation within the anal transition zone.
resultsTwenty-one studies, consisting of 4183 patients (2699 hand-sewn and 1484 stapled IPAA) were included. There was no significant difference in the incidence of postoperative complications between the 2 groups. The incidence of nocturnal seepage and pad usage favored the stapled IPAA (odds ratio [OR] = 2.78, P < 0.001 and OR = 4.12, P = 0.007, respectively). The frequency of defecation was not significantly different between the 2 groups (P = 0.562), nor was the use of antidiarrheal medication (OR = 1.27, P = 0.422). Anorectal physiologic measurements demonstrated a significant reduction in the resting and squeeze pressure in the hand-sewn IPAA group by 13.4 and 14.4 mm Hg, respectively (P < 0.018). The stapled IPAA group showed a higher incidence of dysplasia in the anal transition zone that did not reach statistical significance (OR = 0.42, P = 0.080).
conclusionsBoth techniques had similar early postoperative outcomes; however, stapled IPAA offered improved nocturnal continence, which was reflected in higher anorectal physiologic measurements. A risk of increased incidence of dysplasia in the ATZ may exist in the stapled group that cannot be quantified by this study. We describe a decision algorithm for the choice of IPAA, based on the relative risk of long-term neoplastic transformation.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.