{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T22:41:37Z","timestamp":1773268897647,"version":"3.50.1"},"reference-count":25,"publisher":"International College of Surgeons","issue":"7-8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,7]]},"abstract":"<jats:p>Total proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the standard surgical treatment for patients with ulcerative colitis (UC). The purpose of this study was to investigate the long-term functional outcomes and quality of life (QOL) associated with hand-sewn and stapled IPAA. Ninety-one patients with UC had undergone IPAA using hand-sewn anastomosis with mucosectomy (32 patients) or stapled anastomosis (59 patients) from January 1988 to May 2010. Patients were evaluated according to patient characteristics, postoperative complications, functional outcomes and QOL. The QOL of patients were evaluated using the Medical Outcomes Study Short Form 36 (SF-36) and the Inflammatory Bowel Disease Questionnaire (IBDQ). Numbers of patients with colorectal cancer or dysplasia were significantly greater in the hand-sewn IPAA group (<jats:italic>P<\/jats:italic> &lt; 0.01). These patients had longer disease durations and were older (both <jats:italic>P<\/jats:italic> &lt; 0.01). There was no difference in the incidence of complications between the groups, except for a greater incidence of postoperative anal fistula in the stapled group (<jats:italic>P<\/jats:italic> = 0.03). In the early postsurgery period, both the frequency of bowel movements and the rate of soiling were significantly higher in the hand-sewn group, but in a later period, there was no difference in these events &gt;3 years after surgery. The SF-36 and IBDQ results were similar in the two groups, indicating that hand-sewn and stapled IPAA result in similar QOL in the late postoperative period. Postoperative complications, functional outcomes, and long-term QOL were similar in patients who had received hand-sewn or stapled IPAA.<\/jats:p>","DOI":"10.9738\/intsurg-d-15-00012.1","type":"journal-article","created":{"date-parts":[[2015,11,23]],"date-time":"2015-11-23T19:38:25Z","timestamp":1448307505000},"page":"1169-1176","source":"Crossref","is-referenced-by-count":26,"title":["Comparison of Functional Outcomes of Patients Who Underwent Hand-Sewn or Stapled Ileal Pouch-Anal Anastomosis for Ulcerative Colitis"],"prefix":"10.9738","volume":"100","author":[{"given":"Hiroaki","family":"Ishii","sequence":"first","affiliation":[{"name":"Department of Surgical Oncology, Faculty of Medicine, the University of Tokyo, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazushige","family":"Kawai","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Faculty of Medicine, the University of Tokyo, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keisuke","family":"Hata","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Faculty of Medicine, the University of Tokyo, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasutaka","family":"Shuno","sequence":"additional","affiliation":[{"name":"Department of Surgery, Chigasaki Municipal Hospital, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Nishikawa","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Faculty of Medicine, the University of Tokyo, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshiaki","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Faculty of Medicine, the University of Tokyo, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junichiro","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Faculty of Medicine, the University of Tokyo, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomomichi","family":"Kiyomatsu","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Faculty of Medicine, the University of Tokyo, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroaki","family":"Nozawa","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Faculty of Medicine, the University of Tokyo, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinsuke","family":"Kazama","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Faculty of Medicine, the University of Tokyo, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hironori","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Faculty of Medicine, the University of Tokyo, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soichiro","family":"Ishihara","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Faculty of Medicine, the University of Tokyo, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eiji","family":"Sunami","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Faculty of Medicine, the University of Tokyo, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joji","family":"Kitayama","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Faculty of Medicine, the University of Tokyo, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshiaki","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Faculty of Medicine, the University of Tokyo, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4721","reference":[{"issue":"5","key":"i0020-8868-100-7-1169-b01","series-title":"Gastroenterology","first-page":"1444","article-title":"Colorectal cancer risk and mortality in patients with ulcerative colitis","volume":"103","author":"Langholz\n              E,","year":"1992","unstructured":"Langholz\n              E, \n            \n              Munkholm\n              P, \n            \n              Davidsen\n              M, \n            \n              Binder\n              V.\n            \n          \n          Colorectal cancer risk and mortality in patients with ulcerative colitis. Gastroenterology1992;103(5):1444\u20131451"},{"issue":"3","key":"i0020-8868-100-7-1169-b02","series-title":"Gut","first-page":"329","article-title":"Factors affecting colectomy rate in ulcerative colitis: an epidemiologic study","volume":"31","author":"Leijonmarck\n              CE,","year":"1990","unstructured":"Leijonmarck\n              CE, \n            \n              Persson\n              PG, \n            \n              Hellers\n              G.\n            \n          \n          Factors affecting colectomy rate in ulcerative colitis: an epidemiologic study. Gut1990;31(3):329\u2013333"},{"issue":"24","key":"i0020-8868-100-7-1169-b03","series-title":"World J Gastroenterol","first-page":"3288","article-title":"Ileal pouch surgery for ulcerative colitis","volume":"13","author":"Bach\n              SP,","year":"2007","unstructured":"Bach\n              SP, \n            \n              Mortensen\n              NJ.\n            \n          \n          Ileal pouch surgery for ulcerative colitis. World J Gastroenterol2007;13(24):3288\u20133300"},{"issue":"6130","key":"i0020-8868-100-7-1169-b04","series-title":"Br Med J","first-page":"85","article-title":"Proctocolectomy without ileostomy for ulcerative colitis","volume":"2","author":"Parks\n              AG,","year":"1978","unstructured":"Parks\n              AG, \n            \n              Nicholls\n              RJ.\n            \n          \n          Proctocolectomy without ileostomy for ulcerative colitis. Br Med J1978;2(6130):85\u201388"},{"issue":"1","key":"i0020-8868-100-7-1169-b05","series-title":"Am J Surg","first-page":"90","article-title":"Manometric and functional comparison of ileal pouch anal anastomosis with and without anal manipulation","volume":"161","author":"Tuckson\n              W,","year":"1991","unstructured":"Tuckson\n              W, \n            \n              Lavery\n              I, \n            \n              Fazio\n              V, \n            \n              Oakley\n              J, \n            \n              Church\n              J, \n            \n              Milsom\n              J.\n            \n          \n          Manometric and functional comparison of ileal pouch anal anastomosis with and without anal manipulation. Am J Surg1991;161(1):90\u20135; discussion 5\u20136"},{"issue":"4","key":"i0020-8868-100-7-1169-b06","series-title":"Surgery","first-page":"723","article-title":"Comparison of outcomes after hand-sewn versus stapled ileal pouch-anal anastomosis in 3,109 patients","volume":"146","author":"Kirat\n              HT,","year":"2009","unstructured":"Kirat\n              HT, \n            \n              Remzi\n              FH, \n            \n              Kiran\n              RP, \n            \n              Fazio\n              VW.\n            \n          \n          Comparison of outcomes after hand-sewn versus stapled ileal pouch-anal anastomosis in 3,109 patients. 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J Clin Epidemiol1998;51(11):1037\u20131044"},{"issue":"1","key":"i0020-8868-100-7-1169-b12","series-title":"Gastroenterology","first-page":"7","article-title":"Health-related quality of life after ileoanal pull-through evaluation and assessment of new health status measures","volume":"113","author":"Provenzale\n              D,","year":"1997","unstructured":"Provenzale\n              D, \n            \n              Shearin\n              M, \n            \n              Phillips-Bute\n              BG, \n            \n              Drossman\n              DA, \n            \n              Li\n              Z, \n            \n              Tillinger\n              W\n            \n            et al\n          . Health-related quality of life after ileoanal pull-through evaluation and assessment of new health status measures. Gastroenterology1997;113(1):7\u201314"},{"issue":"7","key":"i0020-8868-100-7-1169-b13","series-title":"J Gastroenterol","first-page":"662","article-title":"Assessment of the Japanese inflammatory bowel disease questionnaire in patients after ileal pouch anal anastomosis for ulcerative colitis","volume":"41","author":"Watanabe\n              K,","year":"2006","unstructured":"Watanabe\n              K, \n            \n              Funayama\n              Y, \n            \n              Fukushima\n              K, \n            \n              Shibata\n              C, \n            \n              Takahashi\n              K, \n            \n              Ogawa\n              H\n            \n            et al\n          . Assessment of the Japanese inflammatory bowel disease questionnaire in patients after ileal pouch anal anastomosis for ulcerative colitis. 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Br J Surg2002;89(2):194\u2013200"},{"issue":"7","key":"i0020-8868-100-7-1169-b16","series-title":"Br J Surg","first-page":"936","article-title":"Pouch-vaginal fistula","volume":"80","author":"Groom\n              JS,","year":"1993","unstructured":"Groom\n              JS, \n            \n              Nicholls\n              RJ, \n            \n              Hawley\n              PR, \n            \n              Phillips\n              RK.\n            \n          \n          Pouch-vaginal fistula. 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Dig Surg2013;30(3):219\u2013224"},{"issue":"3","key":"i0020-8868-100-7-1169-b18","series-title":"J Visc Surg","first-page":"e137","article-title":"Ileal reservoir with ileo-anal anastomosis: long-term complications","volume":"147","author":"Beliard\n              A,","year":"2010","unstructured":"Beliard\n              A, \n            \n              Prudhomme\n              M.\n            \n          \n          Ileal reservoir with ileo-anal anastomosis: long-term complications. J Visc Surg2010;147(3):e137\u2013e144"},{"issue":"1","key":"i0020-8868-100-7-1169-b19","series-title":"Ann Surg","first-page":"18","article-title":"A comparison of hand-sewn versus stapled ileal pouch anal anastomosis (IPAA) following proctocolectomy: a meta-analysis of 4183 patients","volume":"244","author":"Lovegrove\n              RE,","year":"2006","unstructured":"Lovegrove\n              RE, \n            \n              Constantinides\n              VA, \n            \n              Heriot\n              AG, \n            \n              Athanasiou\n              T, \n            \n              Darzi\n              A, \n            \n              Remzi\n              FH\n            \n            et al\n          . A comparison of hand-sewn versus stapled ileal pouch anal anastomosis (IPAA) following proctocolectomy: a meta-analysis of 4183 patients. 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Ann Surg2003;238(3):433\u2013441; discussion 442\u2013445"},{"issue":"7298","key":"i0020-8868-100-7-1169-b21","series-title":"BMJ","first-page":"1357","article-title":"Are quality of life measures patient centred?","volume":"322","author":"Carr\n              AJ,","year":"2001","unstructured":"Carr\n              AJ, \n            \n              Higginson\n              IJ.\n            \n          \n          Are quality of life measures patient centred?\n          BMJ\n          2001;322(7298):1357\u20131360"},{"issue":"6","key":"i0020-8868-100-7-1169-b22","series-title":"Dis Colon Rect","first-page":"866","article-title":"A longitudinal study of quality of life and functional outcome of patients with ulcerative colitis after proctocolectomy with ileal pouch-anal anastomosis","volume":"53","author":"Tulchinsky\n              H,","year":"2010","unstructured":"Tulchinsky\n              H, \n            \n              Dotan\n              I, \n            \n              Halpern\n              Z, \n            \n              Klausner\n              JM, \n            \n              Rabau\n              M.\n            \n          \n          A longitudinal study of quality of life and functional outcome of patients with ulcerative colitis after proctocolectomy with ileal pouch-anal anastomosis. 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Colorectal Dis. 2012;14(5):536\u2013544"},{"issue":"2","key":"i0020-8868-100-7-1169-b24","series-title":"Ann Surg","first-page":"120","article-title":"Ileal pouch-anal anastomoses complications and function in 1005 patients","volume":"222","author":"Fazio\n              VW,","year":"1995","unstructured":"Fazio\n              VW, \n            \n              Ziv\n              Y, \n            \n              Church\n              JM, \n            \n              Oakley\n              JR, \n            \n              Lavery\n              IC, \n            \n              Milsom\n              JW\n            \n            et al\n          . Ileal pouch-anal anastomoses complications and function in 1005 patients. Ann Surg1995;222(2):120\u2013127"},{"issue":"1","key":"i0020-8868-100-7-1169-b25","series-title":"Gastroenterology","first-page":"374","article-title":"Pitfalls of pit pattern diagnosis in ulcerative colitis-associated dysplasia","volume":"126","author":"Hata\n              K,","year":"2004","unstructured":"Hata\n              K, \n            \n              Watanabe\n              T, \n            \n              Motoi\n              T, \n            \n              Nagawa\n              H.\n            \n          \n          Pitfalls of pit pattern diagnosis in ulcerative colitis-associated dysplasia. 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