ArticleUpdates in surgery2025
Comparison of single and double stapling anastomosis in restorative surgery for ulcerative colitis: short- and long-term outcomes and functional results.
Article in Updates in surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundUlcerative colitis (UC) often requires surgery, with restorative proctocolectomy and ileal pouch-anal anastomosis (IPAA) considered the standard treatment. While the double-stapled (DS-IPAA) anastomotic technique remains commonly used, single-stapled (SS-IPAA) techniques, including transanal IPAA (ta-IPAA) and transanal transection with single-stapled anastomosis (TTSS), are gaining popularity. This study compares short-term, long-term, and functional outcomes between DS-IPAA and SS-IPAA in UC patients.
methodsIn this retrospective cohort study, 80 UC patients who underwent a three-stage restorative procedure at a single IBD referral center from June 2018 to June 2023 were analyzed. The patients were divided into two groups: Group 1 (40 DS-IPAA) and Group 2 (40 SS-IPAA, including ta-IPAA and TTSS). The key outcomes assessed included early and late postoperative complications, functional outcomes (measured using the Ileoanal Pouch Syndrome Severity Score, Low Anterior Resection Syndrome score, and IBDQ-32), and quality of life.
resultsThe perioperative complications were similar between the groups. The SS-IPAA group had a significantly shorter hospital stay (6 vs. 8 days, p = 0.008). No significant difference in readmission rates was observed (7.5% DS-IPAA vs. 5.0% SS-IPAA, p = 0.644). The long-term results revealed a higher incidence of cuffitis in the DS-IPAA group (p = 0.002). The functional outcomes were significantly worse in DS-IPAA group, with worse IPSS scores (p = 0.003), higher incidence of major (37.5% vs. 17.5%, p = 0.007), and lower median IBDQ-32 (176 vs. 208, p < 0.001).
conclusionsThis study supports SS-IPAA as a favorable surgical option for UC patients, with implications for individualized surgical decision-making in specialized centers.
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