Experiences with PPH gun stapled ileo or coloanal anastomoses after ultralow rectal resections and proctocolectomies with J pouch reconstructions

Abstract

A new method of stapled ileo and coloanal anastomosis with PPH gun (Johnson and Johnson USA) is presented. On 47 totalcolectomised FAP and UC patients and 9 low rectal benign or clinically T1 or T2N0 rectal tumor resection there was only 5 radiologically proven anastomotic leakadge without serious septic complications. The anal sphincter function after 6 month of the ileoanal anastomosis remained good in 33/39 and acceptable in 6 cases, if the sphincter function was intact praeoperatively. There was no worthening of the moderate praeoperatively observed insufficiency. After the ultra low rectal resections all patients kept the normal anal shpincter function. The procedure seems to be as good as the double stapler method, but there remained no remnant mucosal ring between the anastomsois and the dentate line. An additional advantige of the method, that only one stapler was consumed per patient compared to the two one at the double stapler technic.