[Anastomosis technic of the anus].

The technique of coloanal anastomosis (transanal route n = 27, transphincteric route n = 13) was standardized and also employed in 6 patients with an J-ileumpouch-anal anastomosis after total proctocolectomy and mucosal protectomy: The anal canal is opened by traction sutures and by a simple, non-stretching, semicircular speculum. All sutures are than placed at the anal resection line. The pouch or the (temporary occluded) colon is opened and the stitches are inserted into the proximal part of the anastomosis. All sutures are tied at the end. The technique offered a decreased incidence of secondary anastomotic healing and of pelvic sepsis (1/18) in the last consecutive series, as compared to the earlier series (8/28). In selected cases of coloanal anastomosis (14/40) a covering colostomy could be omitted.