Sideto End Anastomosis

The side-to-end anastomosis, first described in the 1950s, was usually considered the alternative to the end-to-end anastomosis. The advantage of this technique is the optimal blood supply in the site of anastomosis, which is supposed to mean better healing [71, 72].

After becoming less popular as a consequence of the use of stapling devices, it has been recently rein-troduced because of the ever-growing reduction of the colonic J-pouch size [73,74]. Recent studies claim that functional and surgical outcome after side-to-end anastomosis and after colonic J-pouch anastomosis is similar, regardless of whether the reconstruction is performed on the descending colon or on the sigmoid colon [72,75]. For the functional parameters there were only minor detectable advantages of J-pouch in the immediate post-operative period (stool frequency 2.2 vs. 5.4 daily). In order to explain these functional results, retrograde peristaltic waves acting above the anastomotic line from the colic stump have been postulated [73].

According to the Authors, the side-to-end anastomosis is recommended instead of colon J-pouch for technical reasons (narrow pelvis and inadequate bowel length) [72, 73, 75, 76]; however, the only true advantage may be represented by the avoidance of side-to-side anastomosis of the pouch, which makes this procedure faster and cheaper.

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