Randomized Prospective Trial Comparing Ileal Pouch-Anal Anastomosis Performed by Excising the Anal Mucosa to Ileal Pouch-Anal Anastomosis Performed by Preserving the Anal Mucosa

Abstract

Stapled IPAA, which preserves the mucosa of the anal transition zone, confers no apparent early advantage in terms of decreased stool frequency or fewer episodes of fecal incontinence compared to handsewn IPAA, which excises the mucosa. Higher resting pressures in the stapled group coupled with a trend toward less night-time incontinence, however, may portend better function in the stapled group over time. Both operations are safe and result in rapid and profound improvement in quality of life.