Totally stapled abdominal restorative proctocolectomy.

A technique of totally stapled abdominal restorative proctocolectomy is reported in 20 consecutive patients using a 20 x 20 cm J pouch and a stapled ileoanal anastomosis. The stapled ileoanal anastomosis had to be abandoned in three patients because of attempted mucosectomy in one and megarectum in two. One patient receiving steroids had a covering ileostomy. The remaining 16 patients had a totally stapled procedure without a covering ileostomy. Three patients developed serious postoperative morbidity but they were the only patients receiving steroids at the time of the operation. Of the remaining 13 patients none developed serious complications, the median hospital stay was 14 days and the median operating time was 150 min. The operation may be a technical advance particularly in allowing pouch construction without ileostomy in fit patients who are not receiving steroids at the time of operation.