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Title

COMMENTARY ON: LAPAROSCOPIC RESTORATIVE PROCTOCOLECTOMY WITHOUT DIVERTING ILEOSTOMY

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 Start Page 38 | End Page 39

Abstract

 The role of protective ILEOSTOMY for RESTORATIVE PROCTOCOLECTOMY has been debated. Although anastomotic complications can be minimized with protective stoma (1), several authors have reported good outcomes in patients who have undergone RESTORATIVE PROCTOCOLECTOMY without ILEOSTOMY (2-5). A previous report has suggested the possibility of rectal cancer development from the rectal mucosa remnants resulting from ileal pouch–anal anastomosis (IPAA) performed using the stapling technique (6).Therefore, some authors have suggested the selective use of this technique, particularly in patients with familial adenomatous polyposis with rectal sparing, while in other cases, rectal mucosectomy and hand-sewn IPAA have been recommended (7), because the functional or manometric outcome of staple and hand-sewn IPAA is not significantly different (7, 8). However, lifelong surveillance of the IPAA is essential in all patients.

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