P070 Outcomes of hand-sewn versus stapled anastomosis for loop ileostomy reversal after ileal pouch-anal anastomosis in a tertiary center (12th Scientific and Annual Meeting of the European Society of Coloproctology, 20–22 September 2017, CityCube, Berlin, Germany)

Aim: There is evidence towards superiority of stapled closure of loop ileostomy after low rectal anastomosis compared to hand suture in terms of operative time and bowel obstruction rate. The aim of this study is to compare the 30-day outcomes of the two techniques for ileostomy closure after ileal pouch-anal anastomosis (IPAA). Method: Consecutive patients undergoing ileostomy closure after IPAA between 2011–2106 were retrospectively included. Patients’ characteristics and perioperative outcomes were compared. Results: Hand-sewn suture and stapled anastomosis were performed in 280 (84.3%) and 52 (15.7%) patients. The two groups had comparable demographic characteristics. The median operative time was the same between groups (90 min). The incidence of Clavien-Dindo grade I (6.4% vs. 9.6%), II (4.3% vs. 1.9%) and IIIb (1.4% vs. 3.8%), the median days to flatus (2 vs. 2.5, P 0.3) and the length of hospital stay (6 days in both, P 0.9) were similar between groups. A slightly higher although non-significant rate of bowel obstruction was observed in the stapled group (3.8% vs. 2.5%, P 0.6). Conclusion: The loop ileostomy after IPAA should be closed according to the surgeon’s preference using indifferently the hand-sewn or the stapled technique, as the expected outcomes are similar.